Organization
ULTIMATE CARE SUPPORTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL BRAIMA (PRESIDENT)
(614) 868-3821
Entity
Organization
Contact information
Practice address
5300 E MAIN ST STE 100, COLUMBUS, OH 43213-2580
(614) 868-3821
(614) 868-3921
Mailing address
2020 BRICE RD STE 235, REYNOLDSBURG, OH 43068-3464
(614) 868-3821
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
Other
Enumeration date
11/03/2020
Last updated
10/14/2023
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