Provider Demographics
NPI: | 1558024992 |
---|---|
Name: | FREEDOM CARE TX |
Entity type: | Organization |
Organization Name: | FREEDOM CARE TX |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | YOEL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | GABAY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 718-989-9725 |
Mailing Address - Street 1: | 1979 MARCUS AVE STE C115 |
Mailing Address - Street 2: | |
Mailing Address - City: | NEW HYDE PARK |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 11042-1126 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 480-330-8855 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 11111 KATY FWY STE 910 |
Practice Address - Street 2: | |
Practice Address - City: | HOUSTON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77079-2119 |
Practice Address - Country: | US |
Practice Address - Phone: | 718-570-6124 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2021-10-21 |
Last Update Date: | 2022-02-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 253Z00000X | Agencies | In Home Supportive Care | Group - Single Specialty | |
No | 3747P1801X | Nursing Service Related Providers | Technician | Personal Care Attendant | Group - Single Specialty |