Healthcare Provider Details

I. General information

NPI: 1467475467
Provider Name (Legal Business Name): ULTIMATE HOME HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21700 GREENFIELD RD STE 253
OAK PARK MI
48237-2551
US

IV. Provider business mailing address

21700 GREENFIELD RD STE 253
OAK PARK MI
48237-2551
US

V. Phone/Fax

Practice location:
  • Phone: 313-333-1423
  • Fax: 248-557-4563
Mailing address:
  • Phone: 313-333-1423
  • Fax: 248-557-4563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number33192A
License Number StateMI

VIII. Authorized Official

Name: MR. MOHAMMAD FARID
Title or Position: ADMINISTRATOR
Credential: BSC PHYSICAL THERAPY
Phone: 313-333-1423