Healthcare Provider Details

I. General information

NPI: 1407625056
Provider Name (Legal Business Name): ABSOLUTE CARE CORPORATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2023
Last Update Date: 12/22/2023
Certification Date: 12/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4129 W ROOSEVELT DR # A
MILWAUKEE WI
53216-3041
US

IV. Provider business mailing address

4129 W ROOSEVELT DR # A
MILWAUKEE WI
53216-3041
US

V. Phone/Fax

Practice location:
  • Phone: 312-529-0337
  • Fax: 262-393-0387
Mailing address:
  • Phone: 312-529-0337
  • Fax: 262-393-0387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MISS HEAVEN THORNTON
Title or Position: CEO
Credential:
Phone: 312-529-0337