Provider Demographics
NPI:1306262316
Name:FREEDOM UNLIMITED NOW
Entity type:Organization
Organization Name:FREEDOM UNLIMITED NOW
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:R
Authorized Official - Last Name:COSTANZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-551-7730
Mailing Address - Street 1:2825 BEACH BLVD S
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33707-5535
Mailing Address - Country:US
Mailing Address - Phone:727-599-4673
Mailing Address - Fax:
Practice Address - Street 1:2825 BEACH BLVD S
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:FL
Practice Address - Zip Code:33707-5535
Practice Address - Country:US
Practice Address - Phone:727-599-4673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services