Provider Demographics
NPI:1730325093
Name:THE ULTIMATE HOSPICE CARE SERVICES PROVIDERS, INC.
Entity type:Organization
Organization Name:THE ULTIMATE HOSPICE CARE SERVICES PROVIDERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-626-4662
Mailing Address - Street 1:2325 KUEHNER DR
Mailing Address - Street 2:SUITE129
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-3978
Mailing Address - Country:US
Mailing Address - Phone:917-626-4662
Mailing Address - Fax:
Practice Address - Street 1:2325 KUEHNER DR
Practice Address - Street 2:SUITE129
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-3978
Practice Address - Country:US
Practice Address - Phone:917-626-4662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-16
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000457251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based