Organization
ULTIMATE GOAL HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ARREY K ETCHIBANYI D (ADMINISTRATOR)
(301) 982-6477
Entity
Organization
Contact information
Practice address
4920 NIAGARA RD STE 318-320, COLLEGE PARK, MD 20740-1110
(202) 725-0560
(202) 204-5726
Mailing address
4920 NIAGARA RD STE 318-320, COLLEGE PARK, MD 20740-1110
(202) 725-0560
(202) 204-5726
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
Y510229115582
MD
251J00000X
Nursing Care Agency
Y510229115582
MD
302F00000X
Exclusive Provider Organization
Y510229115582
MD
Other
Enumeration date
04/10/2013
Last updated
04/10/2013
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