Provider Demographics
NPI:1710658638
Name:FREEDOM HOSPICE, LLC
Entity Type:Organization
Organization Name:FREEDOM HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HARSHARAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-844-2855
Mailing Address - Street 1:PO BOX 671
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95901-0018
Mailing Address - Country:US
Mailing Address - Phone:707-681-2800
Mailing Address - Fax:
Practice Address - Street 1:2045 JEFFERSON ST STE G
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-1245
Practice Address - Country:US
Practice Address - Phone:707-681-2800
Practice Address - Fax:707-681-2801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-21
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based