1831476258 NPI number — FREEDOM IN HOME SERVICES, LLC

Table of content: (NPI 1831476258)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831476258 NPI number — FREEDOM IN HOME SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FREEDOM IN HOME SERVICES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831476258
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/26/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9314 BINNEY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OMAHA
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68134-4614
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-934-2224
Provider Business Mailing Address Fax Number:
402-431-0803

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9314 BINNEY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OMAHA
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68134-4614
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-934-2224
Provider Business Practice Location Address Fax Number:
402-431-0803
Provider Enumeration Date:
11/14/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MILLION
Authorized Official First Name:
TERESA
Authorized Official Middle Name:
LEANN
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
402-934-2224

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  201104 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10026220400 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 28-7145 . This is a "PTAN" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".