Provider Demographics
NPI:1457864878
Name:FREEMAN RESIDENTIAL SERVICES LLC
Entity Type:Organization
Organization Name:FREEMAN RESIDENTIAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:330-899-9044
Mailing Address - Street 1:3570 EXECUTIVE DR STE 106
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-8712
Mailing Address - Country:US
Mailing Address - Phone:330-899-9044
Mailing Address - Fax:330-899-9055
Practice Address - Street 1:3570 EXECUTIVE DR STE 106
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-8712
Practice Address - Country:US
Practice Address - Phone:330-899-9044
Practice Address - Fax:330-899-9055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.045068.MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHLPN.045068.MEDSOtherOHIO LICENSE CENTER NURSING BOARD