Provider Demographics
NPI:1255454542
Name:FREEDOM HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:FREEDOM HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NANG
Authorized Official - Middle Name:V
Authorized Official - Last Name:THAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-755-8570
Mailing Address - Street 1:4701 N 76TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-4700
Mailing Address - Country:US
Mailing Address - Phone:414-755-8570
Mailing Address - Fax:414-431-0848
Practice Address - Street 1:4701 N 76TH ST STE 300
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-4700
Practice Address - Country:US
Practice Address - Phone:414-755-8570
Practice Address - Fax:414-431-0848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43115000Medicaid
WI100084123Medicaid