Provider Demographics
NPI:1457681363
Name:FREEDOM OF CHOICE SUPPORT SERVICES, INC.
Entity Type:Organization
Organization Name:FREEDOM OF CHOICE SUPPORT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:DONNA
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-895-0295
Mailing Address - Street 1:200 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:FT. LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-1833
Mailing Address - Country:US
Mailing Address - Phone:954-895-0295
Mailing Address - Fax:954-533-1425
Practice Address - Street 1:3800 INVERRARY BLVD STE 100P
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-4316
Practice Address - Country:US
Practice Address - Phone:954-895-0295
Practice Address - Fax:954-533-1425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-28
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL668093298Medicaid
FL668093296Medicaid