Basic Information
| Provider Information | |||||||||
| NPI: | 1952456048 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ABSOLUTE HOME HEALTH CARE INC | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 2003 BLAINE ST | ||||||||
| Address2: | |||||||||
| City: | CALDWELL | ||||||||
| State: | ID | ||||||||
| PostalCode: | 836054344 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2084545655 | ||||||||
| FaxNumber: | 2084540951 | ||||||||
| Practice Location | |||||||||
| Address1: | 2003 BLAINE ST | ||||||||
| Address2: | |||||||||
| City: | CALDWELL | ||||||||
| State: | ID | ||||||||
| PostalCode: | 836054344 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2084545655 | ||||||||
| FaxNumber: | 2084540951 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2007 | ||||||||
| LastUpdateDate: | 12/01/2008 | ||||||||
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| AuthorizedOfficialLastName: | DAHM | ||||||||
| AuthorizedOfficialFirstName: | RHONDA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | REGIONAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2084680140 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | N | Agencies | Home Health | 251J00000X | Y | Agencies | Nursing Care |
ID Information
| ID | Type | State | Issuer | Description | 807056700 | 05 | ID | MEDICAID | 808016503 | 05 | ID | MEDICAID |