Provider Demographics
NPI:1740650811
Name:ABSOLUTE CARE ASSISTED LIVING, LLC
Entity type:Organization
Organization Name:ABSOLUTE CARE ASSISTED LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:BYRD
Authorized Official - Last Name:WESTERN
Authorized Official - Suffix:
Authorized Official - Credentials:BA, CSAC
Authorized Official - Phone:919-673-2146
Mailing Address - Street 1:2905 AUTUMN SUNSET CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-7228
Mailing Address - Country:US
Mailing Address - Phone:919-673-2146
Mailing Address - Fax:919-639-6322
Practice Address - Street 1:431 JUNNY RD
Practice Address - Street 2:
Practice Address - City:ANGIER
Practice Address - State:NC
Practice Address - Zip Code:27501-5653
Practice Address - Country:US
Practice Address - Phone:919-639-6322
Practice Address - Fax:919-639-6322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility