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General NPI Number Information
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NPI Number | 1649612813
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Entity Type | Organization
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Legal Business Name | THE ULTIMATE SERVANT HOME CARE SOLUTION LLC.
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Dates
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Enumeration Date | 07/29/2013
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Last Update Date | 07/29/2013
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Provider Practice Location Address
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Address Line | 1576 CORNELL DR
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City | DAYTON
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State | OH
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Zip | 45406-4728
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Country | US
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Telephone | 937-610-2422
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Fax |
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Provider Business Mailing Address
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Address Line | 1576 CORNELL DR
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City | DAYTON
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State | OH
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Zip | 45406-4728
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Country | US
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Telephone | 937-610-2422
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | CLARA-DENISE COBB
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Credential | M.ED
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Telephone | 937-610-2422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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