Provider Demographics
NPI:1225869878
Name:ABSOLUTECARE OF OHIO, LLC
Entity type:Organization
Organization Name:ABSOLUTECARE OF OHIO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT AND SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:P
Authorized Official - Last Name:FOTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-231-4431
Mailing Address - Street 1:10175 LITTLE PATUXENT PKWY STE 800
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3401
Mailing Address - Country:US
Mailing Address - Phone:667-200-2588
Mailing Address - Fax:
Practice Address - Street 1:7580 NORTHCLIFF AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:OH
Practice Address - Zip Code:44144-3270
Practice Address - Country:US
Practice Address - Phone:216-206-7000
Practice Address - Fax:216-206-6472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health