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General NPI Number Information
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NPI Number | 1023136769
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Entity Type | Organization
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Legal Business Name | ABSOLUTE HOME CARE AGENCY
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 01/30/2015
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Provider Practice Location Address
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Address Line | 895 PETERS CREEK PKWY SUITE 104B
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City | WINSTON SALEM
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State | NC
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Zip | 27103-3857
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Country | US
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Telephone | 336-765-9735
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Fax |
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Provider Business Mailing Address
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Address Line | 895 PETERS CREEK PKWY SUITE 104B
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City | WINSTON SALEM
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State | NC
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Zip | 27103-3857
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Country | US
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Telephone | 336-765-9735
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. TAMMY Y CRAWFORD
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Credential |
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Telephone | 336-765-9735
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HC1587
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License Number State | NC
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