Provider Demographics
NPI:1053582981
Name:FREEDOM CHOICE HOMEHEALTHCARE
Entity type:Organization
Organization Name:FREEDOM CHOICE HOMEHEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TORIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-996-9936
Mailing Address - Street 1:25395 BASIN ST
Mailing Address - Street 2:224
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3821
Mailing Address - Country:US
Mailing Address - Phone:248-996-9936
Mailing Address - Fax:248-996-8174
Practice Address - Street 1:25395 BASIN ST
Practice Address - Street 2:224
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-3821
Practice Address - Country:US
Practice Address - Phone:248-996-9936
Practice Address - Fax:248-996-8174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health