Provider Demographics
NPI:1306093349
Name:FREEDOM HEALTHCARE SERVICES
Entity type:Organization
Organization Name:FREEDOM HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HUNTER
Authorized Official - Middle Name:
Authorized Official - Last Name:FARMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-221-1091
Mailing Address - Street 1:316 STATION ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-1833
Mailing Address - Country:US
Mailing Address - Phone:412-221-1091
Mailing Address - Fax:412-221-2939
Practice Address - Street 1:316 STATION ST
Practice Address - Street 2:SUITE 100
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-1833
Practice Address - Country:US
Practice Address - Phone:412-221-1091
Practice Address - Fax:412-221-2939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-21
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA707264261QM2800X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA707264OtherPA FACILITY LICENSE