Provider Demographics
NPI:1649678236
Name:FREEDOMS LIFESTYLE LLC
Entity type:Organization
Organization Name:FREEDOMS LIFESTYLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-426-8989
Mailing Address - Street 1:33312 GRAND RIVER AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-3124
Mailing Address - Country:US
Mailing Address - Phone:248-426-8989
Mailing Address - Fax:
Practice Address - Street 1:33312 GRAND RIVER AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-3124
Practice Address - Country:US
Practice Address - Phone:248-426-8989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-12
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care