Provider Demographics
NPI:1396424073
Name:ABSOLUTECARE TRANSPORT LLC
Entity type:Organization
Organization Name:ABSOLUTECARE TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JALEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WINSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-965-2633
Mailing Address - Street 1:18227 OLDE FARM RD
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-2553
Mailing Address - Country:US
Mailing Address - Phone:708-965-2633
Mailing Address - Fax:
Practice Address - Street 1:17105 LAFLIN AVE # 2W
Practice Address - Street 2:
Practice Address - City:EAST HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-1854
Practice Address - Country:US
Practice Address - Phone:708-965-2633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No251B00000XAgenciesCase Management