Provider Demographics
NPI:1023427937
Name:ABSOLUTE TARGETED CASE MANAGEMENT SERVICES
Entity type:Organization
Organization Name:ABSOLUTE TARGETED CASE MANAGEMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RANDOLPH
Authorized Official - Middle Name:ADDISON
Authorized Official - Last Name:FERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV
Authorized Official - Phone:407-294-5887
Mailing Address - Street 1:5914 LONG PEAK DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-3244
Mailing Address - Country:US
Mailing Address - Phone:407-294-5887
Mailing Address - Fax:407-294-2624
Practice Address - Street 1:5914 LONG PEAK DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-3244
Practice Address - Country:US
Practice Address - Phone:407-294-5887
Practice Address - Fax:407-294-2624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management