Provider Demographics
NPI:1093933780
Name:ABSOLUTECARE HEALTH SERVICES INC
Entity Type:Organization
Organization Name:ABSOLUTECARE HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:IJEOMA
Authorized Official - Last Name:UDEMBA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:817-442-1100
Mailing Address - Street 1:3609 PARK VIEW DR
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-7171
Mailing Address - Country:US
Mailing Address - Phone:817-442-1100
Mailing Address - Fax:817-442-1105
Practice Address - Street 1:3609 PARK VIEW DR
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-7171
Practice Address - Country:US
Practice Address - Phone:817-442-1100
Practice Address - Fax:817-442-1105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008752251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX459491Medicare PIN
TX459491Medicare Oscar/Certification