Provider Demographics
NPI:1225870561
Name:ULTIMATE BEHAVIORAL CARE LLC
Entity type:Organization
Organization Name:ULTIMATE BEHAVIORAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADU-OFFEI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-681-0724
Mailing Address - Street 1:6640 PARKDALE PL STE V
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-5619
Mailing Address - Country:US
Mailing Address - Phone:336-681-0724
Mailing Address - Fax:
Practice Address - Street 1:6640 PARKDALE PL STE V
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-5619
Practice Address - Country:US
Practice Address - Phone:336-681-0724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-07
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)