Provider Demographics
NPI:1144590274
Name:ABSOLUTE CARE HOME HEALTHCARE, LLC
Entity Type:Organization
Organization Name:ABSOLUTE CARE HOME HEALTHCARE, LLC
Other - Org Name:ABSOLUTE CARE HOME HEALTHCARE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:OMOWUNMI
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:FAGBILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-600-0039
Mailing Address - Street 1:2616 ASPEN DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-4780
Mailing Address - Country:US
Mailing Address - Phone:214-600-0039
Mailing Address - Fax:214-227-2028
Practice Address - Street 1:6653 MCKINNEY RANCH PKWY APT 10305
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-2222
Practice Address - Country:US
Practice Address - Phone:214-600-0039
Practice Address - Fax:214-227-2028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-05
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX015506251S00000X, 253Z00000X
3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX015506Medicaid