MEDICARE: FREETOWN COMMUNITY SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376J00000X	Homemaker

General Provider Information

NPI Number	:	1346924768
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREETOWN COMMUNITY SERVICES LLC

Provider Business Mailing Address
First Line	:	2922 BERRY LANE CT
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-4001
Country	:	US
Telephone Number	:	614-377-9129
Fax Number	:

Provider Business Practice Location Address
First Line	:	2922 BERRY LANE CT
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-4001
Country	:	US
Telephone Number	:	614-377-9129
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	YUSUF SANKOH
Credential	:
Telephone Number	:	614-377-9129

Provider Enumeration Date	:	06/14/2023
Last Update Date	:	06/14/2023

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