Healthcare Provider Details
I. General information
NPI: 1669334652
Provider Name (Legal Business Name): ABSOLUTE HEALTH CARE- WOUND CARE PROS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/26/2025
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
310 MID CONTINENT PLZ STE 303
WEST MEMPHIS AR
72301-1760
US
IV. Provider business mailing address
310 MID CONTINENT PLZ STE 303
WEST MEMPHIS AR
72301-1760
US
V. Phone/Fax
- Phone: 870-739-0664
- Fax:
- Phone: 870-739-0664
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WH1000X |
| Taxonomy | Hospice Registered Nurse |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WW0000X |
| Taxonomy | Wound Care Registered Nurse |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RIQELL
BOGA
Title or Position: CEO
Credential:
Phone: 870-739-0664