Provider Demographics
NPI:1528200250
Name:NEW FREEDOM PRIVATE CARE, INC.
Entity Type:Organization
Organization Name:NEW FREEDOM PRIVATE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER/ VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:505-324-0780
Mailing Address - Street 1:2909 E 20TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87402-4405
Mailing Address - Country:US
Mailing Address - Phone:505-324-0780
Mailing Address - Fax:505-324-0781
Practice Address - Street 1:2909 E 20TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87402-4405
Practice Address - Country:US
Practice Address - Phone:505-324-0780
Practice Address - Fax:505-324-0781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care