Provider Demographics
NPI:1598584948
Name:FREEDOM CARE OF TENNESSEE LLC
Entity type:Organization
Organization Name:FREEDOM CARE OF TENNESSEE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD, NATIONAL EXPANSION
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-959-4115
Mailing Address - Street 1:1979 MARCUS AVE STE C115
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1126
Mailing Address - Country:US
Mailing Address - Phone:617-959-4115
Mailing Address - Fax:
Practice Address - Street 1:1661 INTERNATIONAL DR STE 400
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-1431
Practice Address - Country:US
Practice Address - Phone:615-993-8500
Practice Address - Fax:718-873-2674
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FREEDOM CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health