Healthcare Provider Details

I. General information

NPI: 1881011989
Provider Name (Legal Business Name): ABSOLUTECARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2014
Last Update Date: 03/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 PARK AVE SUITE 200
BALTIMORE MD
21201-5633
US

IV. Provider business mailing address

1040 PARK AVE SUITE 200
BALTIMORE MD
21201-5633
US

V. Phone/Fax

Practice location:
  • Phone: 443-738-0300
  • Fax: 443-738-0301
Mailing address:
  • Phone: 443-738-0300
  • Fax: 443-738-0301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number15738
License Number StateMD

VIII. Authorized Official

Name: MS. SHARON DICKERSON
Title or Position: COO
Credential:
Phone: 404-231-4431