Provider Demographics
NPI:1134302862
Name:FREEDOM HOSPICE LLC
Entity type:Organization
Organization Name:FREEDOM HOSPICE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JODEE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GAILLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-225-3377
Mailing Address - Street 1:1376 W CENTER ST
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-5103
Mailing Address - Country:US
Mailing Address - Phone:801-225-3387
Mailing Address - Fax:801-225-3387
Practice Address - Street 1:1376 W CENTER ST
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-5103
Practice Address - Country:US
Practice Address - Phone:801-225-3387
Practice Address - Fax:801-225-3387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based