Provider Demographics
NPI:1255699088
Name:FREEDOM IN-HOME CARE
Entity type:Organization
Organization Name:FREEDOM IN-HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:FARRALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-535-1542
Mailing Address - Street 1:1020 PRINCE FREDERICK BLVD
Mailing Address - Street 2:BOX 4, SUITE 300
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-3932
Mailing Address - Country:US
Mailing Address - Phone:410-535-1542
Mailing Address - Fax:410-535-1892
Practice Address - Street 1:1020 PRINCE FREDERICK BLVD
Practice Address - Street 2:BOX 4, SUITE 300
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-3932
Practice Address - Country:US
Practice Address - Phone:410-535-1542
Practice Address - Fax:410-535-1892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3099251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health