Provider Demographics
NPI:1417601238
Name:FRESHAIR HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:FRESHAIR HEALTH SERVICES LLC
Other - Org Name:FRESHAIR HEALTH SERVICES LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:CRNP-PMH, CRNP-ADULT
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:EMASEALU
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:832-434-8900
Mailing Address - Street 1:5004 HONEYGO CENTER DR STE 102
Mailing Address - Street 2:
Mailing Address - City:PERRY HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21128-8964
Mailing Address - Country:US
Mailing Address - Phone:832-434-8900
Mailing Address - Fax:
Practice Address - Street 1:28 TOLLGATE RD
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-3348
Practice Address - Country:US
Practice Address - Phone:832-434-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-10
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center