MEDICARE: ULTIMATE CARE PLUS HOME HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		CA

General Provider Information

NPI Number	:	1356332159
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ULTIMATE CARE PLUS HOME HEALTH

Provider Business Mailing Address
First Line	:	4138 EAGLE ROCK BLVD
Second Line	:	SUITE B
City	:	LOS ANGELES
State	:	CA
Zip	:	90065-4442
Country	:	US
Telephone Number	:	323-999-2505
Fax Number	:	323-999-2507

Provider Business Practice Location Address
First Line	:	4138 EAGLE ROCK BLVD
Second Line	:	SUITE B
City	:	LOS ANGELES
State	:	CA
Zip	:	90065-4442
Country	:	US
Telephone Number	:	323-999-2505
Fax Number	:	323-999-2507

Authorized Official
Title or Position	:	ADMINISTRATOR DPCS
Name	:	MS. CHERYL ORLEANS
Credential	:	RN
Telephone Number	:	323-999-2505

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	08/22/2020

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Directions to “ULTIMATE CARE PLUS HOME HEALTH ” Practice Location

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