Organization
ABSOLUTE CARE OF HAMMOND, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PHYLLIS BERNADETTE LARK (OWNER)
(219) 933-8157
Entity
Organization
Contact information
Practice address
534 CONKEY ST, 2, HAMMOND, IN 46324-1100
(219) 933-8157
(219) 933-8273
Mailing address
534 CONKEY ST, 2, HAMMOND, IN 46324-1100
(219) 933-8157
(219) 933-8273
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200861750A
—
IN
05
—
200861760
—
IN
Enumeration date
07/26/2007
Last updated
07/26/2007
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