Organization
ABSOLUTE PERSONAL CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BASIL ODUSANYA (DIRECTOR)
(770) 909-4564
Entity
Organization
Contact information
Practice address
7285 DEXTER DR, RIVERDALE, GA 30296-3300
(770) 909-4564
Mailing address
7285 DEXTER DR, RIVERDALE, GA 30296-3300
(770) 909-4564
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
031012761
GA
Other
Enumeration date
09/23/2010
Last updated
09/23/2010
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