Provider Demographics
NPI:1225497902
Name:FREEDOM FIRST SUPPORT SERVICES, LLC
Entity Type:Organization
Organization Name:FREEDOM FIRST SUPPORT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CHARTRAND
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:207-649-1745
Mailing Address - Street 1:5 WARREN TER
Mailing Address - Street 2:
Mailing Address - City:WINSLOW
Mailing Address - State:ME
Mailing Address - Zip Code:04901-7612
Mailing Address - Country:US
Mailing Address - Phone:207-649-1745
Mailing Address - Fax:207-861-7037
Practice Address - Street 1:5 WARREN TER
Practice Address - Street 2:
Practice Address - City:WINSLOW
Practice Address - State:ME
Practice Address - Zip Code:04901-7612
Practice Address - Country:US
Practice Address - Phone:207-649-1745
Practice Address - Fax:207-861-7037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities