Healthcare Provider Details

I. General information

NPI: 1265023196
Provider Name (Legal Business Name): ABSOLUTE CARE GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2021
Last Update Date: 08/17/2021
Certification Date: 08/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 E BALTIMORE AVE REAR
CLIFTON HEIGHTS PA
19018-1602
US

IV. Provider business mailing address

55 E BALTIMORE AVE REAR
CLIFTON HEIGHTS PA
19018-1602
US

V. Phone/Fax

Practice location:
  • Phone: 215-779-1970
  • Fax: 215-494-3562
Mailing address:
  • Phone: 215-779-1970
  • Fax: 215-494-3562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: OSARU ANYUMBA
Title or Position: ADMINISTRATOR
Credential:
Phone: 215-779-1970