Healthcare Provider Details

I. General information

NPI: 1891508222
Provider Name (Legal Business Name): ULTIMATE HEALTH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 OAK ST SAME
BROCKTON MA
02301-0230
US

IV. Provider business mailing address

42 OAK ST SAME
BROCKTON MA
02301
US

V. Phone/Fax

Practice location:
  • Phone: 774-704-0129
  • Fax:
Mailing address:
  • Phone: 774-704-0129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CARLA TORRES
Title or Position: OWNER
Credential: LMHC
Phone: 774-704-0129