Healthcare Provider Details

I. General information

NPI: 1992530513
Provider Name (Legal Business Name): ABSOLUTECARE OF OHIO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2024
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 S MAIN ST STE 100
AKRON OH
44308-1416
US

IV. Provider business mailing address

10175 LITTLE PATUXENT PKWY STE 800
COLUMBIA MD
21044-3401
US

V. Phone/Fax

Practice location:
  • Phone: 667-400-0483
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: GREGORY P. FOTI
Title or Position: PRESIDENT
Credential: MD
Phone: 404-231-4431