Provider Demographics
NPI:1427395946
Name:FREEDOM HOSPICE, LLC
Entity Type:Organization
Organization Name:FREEDOM HOSPICE, LLC
Other - Org Name:HERITAGE HOSPICE AND PALLIATIVE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LATINIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-864-4901
Mailing Address - Street 1:7215 E 21ST ST STE A
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-1777
Mailing Address - Country:US
Mailing Address - Phone:463-202-2926
Mailing Address - Fax:463-202-2176
Practice Address - Street 1:7215 E 21ST ST STE A
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-1777
Practice Address - Country:US
Practice Address - Phone:463-202-2926
Practice Address - Fax:463-202-2176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-04
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120122031251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based