Provider Demographics
NPI:1841927787
Name:FREEDOM BY FAITH, LLC
Entity type:Organization
Organization Name:FREEDOM BY FAITH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GARDUNO
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN, CCM
Authorized Official - Phone:313-721-0101
Mailing Address - Street 1:46670 CLAXTON DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48111-8677
Mailing Address - Country:US
Mailing Address - Phone:313-721-0101
Mailing Address - Fax:
Practice Address - Street 1:46670 CLAXTON DR
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48111-8677
Practice Address - Country:US
Practice Address - Phone:313-721-0101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374K00000XNursing Service Related ProvidersReligious Nonmedical PractitionerGroup - Single Specialty