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Organization
FREEMAN SUPPORT CARE SERVICE CORP
Active
Organization
FREEMAN SUPPORT CARE SERVICE CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOLE FREEMAN (OWNER/PRESIDENT)
(813) 917-4080
Entity
Organization
Contact information
Practice address
11424 N 53RD ST, TEMPLE TERRACE, FL 33617-2216
(813) 985-2104
(813) 985-2101
Mailing address
PO BOX 1054, THONOTOSASSA, FL 33592-1054
(813) 917-4080
(813) 985-2101
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
261QD1600X
Developmental Disabilities Clinic/Center
—
NULL
385H00000X
Respite Care
—
NULL
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
NULL
Other
Enumeration date
06/21/2019
Last updated
06/21/2019
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