Provider Demographics
NPI:1669717427
Name:ABSOLUTE HEALTHCARE
Entity type:Organization
Organization Name:ABSOLUTE HEALTHCARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED PRACTICAL NURSE
Authorized Official - Prefix:MR
Authorized Official - First Name:JUDE
Authorized Official - Middle Name:U
Authorized Official - Last Name:IFEBI
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:646-330-0896
Mailing Address - Street 1:172 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10303-2724
Mailing Address - Country:US
Mailing Address - Phone:646-330-0896
Mailing Address - Fax:267-393-8199
Practice Address - Street 1:172 LAKE AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10303-2724
Practice Address - Country:US
Practice Address - Phone:646-330-0896
Practice Address - Fax:267-393-8199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY296840313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility