Provider Demographics
NPI:1578245825
Name:ULTIMATE HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:ULTIMATE HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PROGRAM
Authorized Official - Prefix:
Authorized Official - First Name:KOLAWOLE
Authorized Official - Middle Name:WAHAB
Authorized Official - Last Name:ANIMASAUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-769-5904
Mailing Address - Street 1:4429 ROSEBRIAR AVE
Mailing Address - Street 2:
Mailing Address - City:VADNAIS HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55127-3556
Mailing Address - Country:US
Mailing Address - Phone:651-769-5904
Mailing Address - Fax:
Practice Address - Street 1:4429 ROSEBRIAR AVE
Practice Address - Street 2:
Practice Address - City:VADNAIS HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55127-3556
Practice Address - Country:US
Practice Address - Phone:651-769-5904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health