MEDICARE: ULTIMACARE HOME HEALTH INC.

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	237514	MI
2	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811978703
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ULTIMACARE HOME HEALTH INC.

Provider Business Mailing Address
First Line	:	2785 GARFIELD RD N STE C
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-5168
Country	:	US
Telephone Number	:	231-943-2552
Fax Number	:	231-943-2555

Provider Business Practice Location Address
First Line	:	2785 GARFIELD RD N STE C
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49686-5168
Country	:	US
Telephone Number	:	231-943-2552
Fax Number	:	231-943-2555

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. SAMANTHA GARCIA
Credential	:
Telephone Number	:	231-943-2552

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	03/16/2023

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