Provider Demographics
NPI:1114691706
Name:FREE ZONE HOME CARE LLC
Entity Type:Organization
Organization Name:FREE ZONE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ISRAEL
Authorized Official - Middle Name:GEBEYEHU
Authorized Official - Last Name:GEBREEGZIABHAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-457-1366
Mailing Address - Street 1:4207 OCONNELL ST
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-6791
Mailing Address - Country:US
Mailing Address - Phone:610-457-1366
Mailing Address - Fax:
Practice Address - Street 1:3601 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-5637
Practice Address - Country:US
Practice Address - Phone:610-457-1366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care