Provider Demographics
NPI:1063602241
Name:NEW FREEDOM HOME HEALTH CARE
Entity type:Organization
Organization Name:NEW FREEDOM HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN,MSN
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARYANN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-299-7411
Mailing Address - Street 1:481 S WINDCREST DR
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-5319
Mailing Address - Country:US
Mailing Address - Phone:708-299-7411
Mailing Address - Fax:
Practice Address - Street 1:481 S WINDCREST DR
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-5319
Practice Address - Country:US
Practice Address - Phone:708-299-7411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health