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General NPI Number Information
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NPI Number | 1770060014
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Entity Type | Organization
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Legal Business Name | ULTRA CARE HOME SERVICES LLC
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Dates
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Enumeration Date | 07/19/2018
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Last Update Date | 11/06/2020
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Provider Practice Location Address
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Address Line | 7353 DALE AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63117
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Country | US
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Telephone | 314-224-5354
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Fax | 314-224-5356
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Provider Business Mailing Address
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Address Line | 7353 DALE AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63117-2241
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Country | US
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Telephone | 314-224-5354
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Fax | 314-224-5356
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Authorized Official
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Title or Position | OWNER
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Name | BRITTANY GABRIELLE SEALS
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Credential |
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Telephone | 314-478-9131
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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 | MO
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