MEDICARE: ABSOLUT CARITAS HOMES 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
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1528641222
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABSOLUT CARITAS HOMES LLC

Provider Business Mailing Address
First Line	:	142 E JOAN D ARC AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-4705
Country	:	US
Telephone Number	:	832-219-5808
Fax Number	:

Provider Business Practice Location Address
First Line	:	142 E JOAN D ARC AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-4705
Country	:	US
Telephone Number	:	832-219-5808
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TABI PASCAL DEGOH
Credential	:
Telephone Number	:	832-219-5808

Provider Enumeration Date	:	04/30/2021
Last Update Date	:	02/25/2025

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Directions to “ABSOLUT CARITAS HOMES LLC ” Practice Location

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