# ULTIMATE GOAL HOME CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972946820
- **Authorized official:** MR. ARREY K ETCHIBANYI D (ADMINISTRATOR)
- **Authorized official phone:** (301) 982-6477

## Contact information

- **Practice address:** 4920 NIAGARA RD STE 318-320, COLLEGE PARK, MD 20740-1110
- **Practice address phone:** (202) 725-0560
- **Practice address fax:** (202) 204-5726
- **Mailing address:** 4920 NIAGARA RD STE 318-320, COLLEGE PARK, MD 20740-1110
- **Mailing address phone:** (202) 725-0560
- **Mailing address fax:** (202) 204-5726

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | Y510229115582 | MD | Yes |
| 251J00000X | Nursing Care Agency | Y510229115582 | MD | — |
| 302F00000X | Exclusive Provider Organization | Y510229115582 | MD | — |

## Other

- **Enumeration date:** 04/10/2013
- **Last updated:** 04/10/2013