Provider Demographics
NPI:1518166131
Name:ARC FREEDOM SQUARE LLC
Entity Type:Organization
Organization Name:ARC FREEDOM SQUARE LLC
Other - Org Name:THE INN AT FREEDOM SQUARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-221-2250
Mailing Address - Street 1:10801 JOHNSON BLVD
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-4746
Mailing Address - Country:US
Mailing Address - Phone:727-398-0379
Mailing Address - Fax:
Practice Address - Street 1:10801 JOHNSON BLVD
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-4746
Practice Address - Country:US
Practice Address - Phone:727-398-0379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BROOKDALE SENIOR LIVING INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility