Organization
ULTIMATE HOME CARE AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIANA BOATENG HAGAN (ADMINISTRATOR)
(215) 620-8807
Entity
Organization
Contact information
Practice address
901 W GIRARD AVE, STE 105, PHILADELPHIA, PA 19123-1216
(215) 620-8807
Mailing address
901 W GIRARD AVE, STE 105, PHILADELPHIA, PA 19123-1216
(215) 620-8807
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
32023601
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32023601
—
PA
Enumeration date
03/15/2017
Last updated
03/15/2017
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