Provider Demographics
NPI:1346766805
Name:FREEDOM SENIOR SHARE, LLC
Entity Type:Organization
Organization Name:FREEDOM SENIOR SHARE, LLC
Other - Org Name:FREEDOM ADULT DAY HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NACHIKETA
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATT
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MBBS
Authorized Official - Phone:502-243-7383
Mailing Address - Street 1:9908 RIVER TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40229-5203
Mailing Address - Country:US
Mailing Address - Phone:502-243-7383
Mailing Address - Fax:800-214-6418
Practice Address - Street 1:4511 BARDSTOWN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-4001
Practice Address - Country:US
Practice Address - Phone:502-243-7383
Practice Address - Fax:800-214-6418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-16
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X, 3747P1801X
KY750201261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day CareGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty