MEDICARE: FREEDOM NOW HOME CARE-NC, 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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1619576311
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREEDOM NOW HOME CARE-NC, LLC

Provider Business Mailing Address
First Line	:	9635 SOUTHERN PINE BLVD OFC PARK
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28273-5540
Country	:	US
Telephone Number	:	980-221-1273
Fax Number	:

Provider Business Practice Location Address
First Line	:	9635 SOUTHERN PINE BLVD OFC PARK
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28273-5540
Country	:	US
Telephone Number	:	980-221-1273
Fax Number	:

Authorized Official
Title or Position	:	AGENT DIRECTOR
Name	:	MISS KAHLENA M EDWARDS
Credential	:	MBA
Telephone Number	:	814-418-9286

Provider Enumeration Date	:	10/22/2020
Last Update Date	:	02/09/2022

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