Provider Demographics
NPI:1184940744
Name:ULTRA HEALTHCARE SERVICES
Entity type:Organization
Organization Name:ULTRA HEALTHCARE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:OKON
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-741-4085
Mailing Address - Street 1:10998 S WILCREST DR
Mailing Address - Street 2:SUITE 282
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-3564
Mailing Address - Country:US
Mailing Address - Phone:281-741-4085
Mailing Address - Fax:
Practice Address - Street 1:10998 S WILCREST DR
Practice Address - Street 2:SUITE 282
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-3564
Practice Address - Country:US
Practice Address - Phone:281-741-4085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health