Provider Demographics
NPI:1881136752
Name:ABSOLUTE CARE OF ALASKA, LLC.
Entity type:Organization
Organization Name:ABSOLUTE CARE OF ALASKA, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FLEDZ
Authorized Official - Middle Name:LERIOS
Authorized Official - Last Name:LASTIMOSO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:907-727-1965
Mailing Address - Street 1:4601 E 104TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-6514
Mailing Address - Country:US
Mailing Address - Phone:907-222-4840
Mailing Address - Fax:
Practice Address - Street 1:4450 CORDOVA ST
Practice Address - Street 2:SUITE 100
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-7273
Practice Address - Country:US
Practice Address - Phone:907-770-1036
Practice Address - Fax:907-770-1032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKPCGX253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care