Provider Demographics
NPI:1366064412
Name:FREEDOM LLC
Entity type:Organization
Organization Name:FREEDOM LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:COFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-493-1440
Mailing Address - Street 1:27 1ST AVE NE STE 205
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-6219
Mailing Address - Country:US
Mailing Address - Phone:828-493-1440
Mailing Address - Fax:
Practice Address - Street 1:27 1ST AVE NE STE 205
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-6219
Practice Address - Country:US
Practice Address - Phone:828-493-1440
Practice Address - Fax:828-256-0186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-12
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCHC3641OtherNORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES