Healthcare Provider Details

I. General information

NPI: 1023867413
Provider Name (Legal Business Name): FREE AIR LIFE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2024
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1413 N. ALTA AVE
DINUBA CA
93618
US

IV. Provider business mailing address

PO BOX 6
DINUBA CA
93618-0006
US

V. Phone/Fax

Practice location:
  • Phone: 559-681-3287
  • Fax:
Mailing address:
  • Phone: 559-681-3287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: BILLIEJEAN NEWLIN
Title or Position: OFFICE / PROJECT MANAGER
Credential:
Phone: 559-681-3287