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General NPI Number Information
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NPI Number | 1871300418
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Entity Type | Organization
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Legal Business Name | ULTRA LIMITED LIABILITY COMPANY
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Dates
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Enumeration Date | 12/17/2024
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 1209 MOUNTAIN ROAD PL NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-7845
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Country | US
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Telephone | 520-380-7533
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Fax |
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Provider Business Mailing Address
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Address Line | 1209 MOUNTAIN ROAD PL NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-7845
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Country | US
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Telephone | 520-380-7533
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | MR. THOMAS C. BATTLE III
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Credential |
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Telephone | 520-380-7533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LC1500X
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Taxonomy Name | Community Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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