=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740872894
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ABSOLUTE RESIDENTIAL SERVICES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/10/2021
-----------------------------------------------------
Last Update Date | 02/10/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1127 INTERNATIONAL PKWY STE 119
-----------------------------------------------------
City | FREDERICKSBURG
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22406-1142
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-436-1735
-----------------------------------------------------
Fax | 703-436-2174
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1127 INTERNATIONAL PKWY STE 119
-----------------------------------------------------
City | FREDERICKSBURG
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22406-1142
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-436-1735
-----------------------------------------------------
Fax | 703-436-2174
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/OWNER
-----------------------------------------------------
Name | OBENG AMANIAMPONG
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 703-436-1735
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 320600000X
-----------------------------------------------------
Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------