Provider Demographics
NPI:1316682255
Name:FREEDOM HOME CARE
Entity type:Organization
Organization Name:FREEDOM HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VILAYPHONE
Authorized Official - Middle Name:
Authorized Official - Last Name:THAWNGHMUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-753-1140
Mailing Address - Street 1:15 N 20TH ST
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-1701
Mailing Address - Country:US
Mailing Address - Phone:269-753-1140
Mailing Address - Fax:
Practice Address - Street 1:15 N 20TH ST
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-1701
Practice Address - Country:US
Practice Address - Phone:269-753-1140
Practice Address - Fax:269-753-1148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care