NPI 1336457449

Absolute Personal Care Home

Organisation Exclusive Provider Organization Riverdale, GA

Practice location

Address: 7285 Dexter Dr, Riverdale, GA 30296-3300
Phone: (770) 909-4564

Authorised official

Name: Basil Odusanya
Title: Director
Phone: (770) 909-4564

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 031012761 (GA)

Other Exclusive Provider Organization providers in Georgia →

Registry record

NPI: 1336457449
Entity type: Organization
NPI issued: 23 Sep 2010
Record last updated: 23 Sep 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.