Provider Demographics
NPI:1558102418
Name:FREEDOM INTEGRATED WELLNESS, LLC
Entity type:Organization
Organization Name:FREEDOM INTEGRATED WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:ESHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-900-6950
Mailing Address - Street 1:17500 N PERIMETER DR # 110
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-7800
Mailing Address - Country:US
Mailing Address - Phone:480-900-6950
Mailing Address - Fax:
Practice Address - Street 1:17500 N PERIMETER DR # 110
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7800
Practice Address - Country:US
Practice Address - Phone:480-900-6950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-04
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty