Organization
FREEDOM VILLA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. OLAYEMI SANNI RN (ADMINISTRATIVE DIRECTOR)
(248) 895-7028
Entity
Organization
Contact information
Practice address
3509 ELIZABETH LAKE RD STE 102, WATERFORD, MI 48328-3003
(248) 681-3658
(248) 681-3658
Mailing address
3509 ELIZABETH LAKE RD STE 102, WATERFORD, MI 48328-3003
(248) 681-3658
(248) 681-3658
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
AS630299536
MI
320800000X
Mental Illness Community Based Residential Treatment Facility
AS630377897
MI
Other
Enumeration date
05/16/2017
Last updated
07/21/2022
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