Organization
FREEDOM CUSTOMIZED CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DANITA ELLEN KNUCKLES (OWNER)
(314) 494-1560
Entity
Organization
Contact information
Practice address
6614 W FLORISSANT AVE, UNIT 3A, JENNINGS, MO 63136-3646
(314) 494-1560
Mailing address
6614 W FLORISSANT AVE, UNIT 3A, JENNINGS, MO 63136-3646
(314) 494-1560
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
07/21/2014
Last updated
07/21/2014
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