Healthcare Provider Details

I. General information

NPI: 1649188608
Provider Name (Legal Business Name): ULTIMATE HOMEHEALTH AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3595 E FOUNTAIN BLVD STE 240
COLORADO SPRINGS CO
80910-7715
US

IV. Provider business mailing address

3595 E FOUNTAIN BLVD STE 240
COLORADO SPRINGS CO
80910-7715
US

V. Phone/Fax

Practice location:
  • Phone: 323-636-5005
  • Fax:
Mailing address:
  • Phone: 323-636-5005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: TIRFESA EGU
Title or Position: CO-OWNER
Credential:
Phone: 323-636-5005