Healthcare Provider Details

I. General information

NPI: 1548657554
Provider Name (Legal Business Name): ABSOLUTE HEALTHCARE RESOURCES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2015
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1039 BLADENSBURG RD NE
WASHINGTON DC
20002-2922
US

IV. Provider business mailing address

1039 BLADENSBURG RD NE
WASHINGTON DC
20002-2922
US

V. Phone/Fax

Practice location:
  • Phone: 202-507-8139
  • Fax: 703-205-2413
Mailing address:
  • Phone: 202-507-8139
  • Fax: 703-205-2413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberCM PROVIDER
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. PETER A ATEMNKENG
Title or Position: ADMINISTRATOR
Credential:
Phone: 703-205-2412