# FREEMAN SUPPORT CARE SERVICE CORP

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952962821
- **Authorized official:** JACOLE FREEMAN (OWNER/PRESIDENT)
- **Authorized official phone:** (813) 917-4080

## Contact information

- **Practice address:** 11424 N 53RD ST, TEMPLE TERRACE, FL 33617-2216
- **Practice address phone:** (813) 985-2104
- **Practice address fax:** (813) 985-2101
- **Mailing address:** PO BOX 1054, THONOTOSASSA, FL 33592-1054
- **Mailing address phone:** (813) 917-4080
- **Mailing address fax:** (813) 985-2101

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |
| 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