Provider Demographics
NPI:1700439239
Name:ULTIMATE CARE SERVICES LLC
Entity type:Organization
Organization Name:ULTIMATE CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JULIANA
Authorized Official - Middle Name:NTIRIWA
Authorized Official - Last Name:ADEGBITE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:240-422-3946
Mailing Address - Street 1:4929 GREEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:MD
Mailing Address - Zip Code:21770-9710
Mailing Address - Country:US
Mailing Address - Phone:301-865-3307
Mailing Address - Fax:301-865-0293
Practice Address - Street 1:4929 GREEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:MD
Practice Address - Zip Code:21770-9710
Practice Address - Country:US
Practice Address - Phone:301-865-3307
Practice Address - Fax:301-865-0293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5424151700Medicaid