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NPI Code Detail

MEDICARE: ABSOLUTE CARE PROVIDERS LLC

MEDICARE: ABSOLUTE CARE PROVIDERS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1366125486
Entity Type Code : Organization
Provider Name (Legal Business Name) : ABSOLUTE CARE PROVIDERS LLC
Provider Business Mailing Address
First Line : 7132 PORTLAND AVE
Second Line :
City : RICHFIELD
State : MN
Zip : 55423-3264
Country : US
Telephone Number : 651-274-7262
Fax Number :
Provider Business Practice Location Address
First Line : 7132 PORTLAND AVE
Second Line :
City : RICHFIELD
State : MN
Zip : 55423-3264
Country : US
Telephone Number : 651-274-7262
Fax Number :
Authorized Official
Title or Position : GENERAL MANAGER
Name : LEUL GEBRE HABTE
Credential :
Telephone Number : 651-274-7262
Provider Enumeration Date : 08/08/2023
Last Update Date : 03/03/2026

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Directions to “ABSOLUTE CARE PROVIDERS LLC ” Practice Location

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