Provider Demographics
NPI:1013308980
Name:ULTIMATE HOME CARE LLC
Entity Type:Organization
Organization Name:ULTIMATE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDOGHOGHO
Authorized Official - Middle Name:MAGNUS
Authorized Official - Last Name:IGBINOSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-457-0182
Mailing Address - Street 1:100 CUMMINGS CTR
Mailing Address - Street 2:SUITE 328D
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-6115
Mailing Address - Country:US
Mailing Address - Phone:978-522-5800
Mailing Address - Fax:978-522-5800
Practice Address - Street 1:100 CUMMINGS CTR
Practice Address - Street 2:SUITE 328D
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6115
Practice Address - Country:US
Practice Address - Phone:978-522-5800
Practice Address - Fax:978-522-5800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-12
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health