Provider Demographics
NPI:1699112862
Name:FREEDOM AT HOME DIALYSIS LLC
Entity type:Organization
Organization Name:FREEDOM AT HOME DIALYSIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LOU
Authorized Official - Middle Name:
Authorized Official - Last Name:LOSANES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-402-3450
Mailing Address - Street 1:4893 E FM 552
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-9731
Mailing Address - Country:US
Mailing Address - Phone:972-772-2565
Mailing Address - Fax:972-772-2566
Practice Address - Street 1:4893 E FM 552
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-9731
Practice Address - Country:US
Practice Address - Phone:972-772-2565
Practice Address - Fax:972-772-2566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-29
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health