Provider Demographics
NPI:1609532316
Name:FREE SPIRIT HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:FREE SPIRIT HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR/DIRECTOR OF NURSE
Authorized Official - Prefix:
Authorized Official - First Name:RASHIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BANGURA
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTRED NURSE
Authorized Official - Phone:614-806-6816
Mailing Address - Street 1:5900 ROCHE DR STE 607
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-3272
Mailing Address - Country:US
Mailing Address - Phone:614-806-6816
Mailing Address - Fax:
Practice Address - Street 1:5900 ROCHE DR STE 607
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3272
Practice Address - Country:US
Practice Address - Phone:614-806-6816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health