Healthcare Provider Details

I. General information

NPI: 1558779645
Provider Name (Legal Business Name): ABSOLUTE CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2014
Last Update Date: 08/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N 21ST ST
MONROE LA
71201-6532
US

IV. Provider business mailing address

500 N 21ST ST
MONROE LA
71201-6532
US

V. Phone/Fax

Practice location:
  • Phone: 318-450-4911
  • Fax:
Mailing address:
  • Phone: 318-450-4911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number2203781066
License Number StateLA

VIII. Authorized Official

Name: MARKUS BOSLEY
Title or Position: ADMINISTRATOR
Credential:
Phone: 318-791-9805