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General NPI Number Information
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NPI Number | 1710058573
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Entity Type | Organization
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Legal Business Name | ABSOLUTE HOME CARE INC.
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 07/25/2017
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Provider Practice Location Address
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Address Line | 2860 E FLAMINGO RD STE K
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City | LAS VEGAS
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State | NV
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Zip | 89121-5270
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Country | US
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Telephone | 702-318-5005
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Fax | 702-318-5006
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Provider Business Mailing Address
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Address Line | 2860 E FLAMINGO RD SUITE K
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City | LAS VEGAS
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State | NV
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Zip | 89121
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Country | US
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Telephone | 702-318-5005
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Fax | 702-318-5006
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. EDGAR VALENTIN JIMENEZ
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Credential |
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Telephone | 702-318-5005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 20031450181
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License Number State | NV
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