Provider Demographics
NPI:1164024238
Name:FREELEE INTEGRATED HEALTH WEALTH LLC
Entity Type:Organization
Organization Name:FREELEE INTEGRATED HEALTH WEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/HOLISTIC HEALTH PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DSOCSCI, BCHHP, CFLE
Authorized Official - Phone:302-607-8053
Mailing Address - Street 1:3125 NEW CASTLE AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-2174
Mailing Address - Country:US
Mailing Address - Phone:302-277-7161
Mailing Address - Fax:302-566-2853
Practice Address - Street 1:3125 NEW CASTLE AVE STE 3
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-2174
Practice Address - Country:US
Practice Address - Phone:302-277-7161
Practice Address - Fax:302-566-2853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-12
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE250699919Medicaid