Provider Demographics
NPI:1629556824
Name:ABSOLUTECARE INC
Entity Type:Organization
Organization Name:ABSOLUTECARE INC
Other - Org Name:ABSOLUTECARE RSA INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADEBISI
Authorized Official - Middle Name:SHERIFAT
Authorized Official - Last Name:SANNI
Authorized Official - Suffix:
Authorized Official - Credentials:BSC, MSC,RN
Authorized Official - Phone:301-577-6500
Mailing Address - Street 1:7515 ANNAPOLIS RD STE 206
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-1740
Mailing Address - Country:US
Mailing Address - Phone:301-577-6500
Mailing Address - Fax:240-467-3151
Practice Address - Street 1:7515 ANNAPOLIS RD STE 206
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20784-1740
Practice Address - Country:US
Practice Address - Phone:301-577-6500
Practice Address - Fax:240-467-3151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-31
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
MDR3218251T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5156803500Medicaid