Healthcare Provider Details

I. General information

NPI: 1073154241
Provider Name (Legal Business Name): FREEDOM NOW, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2019
Last Update Date: 09/01/2021
Certification Date: 09/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 SE 23RD AVE
BOYNTON BEACH FL
33435-7620
US

IV. Provider business mailing address

14000 S MILITARY TRL STE 208
DELRAY BEACH FL
33484-2654
US

V. Phone/Fax

Practice location:
  • Phone: 561-819-0620
  • Fax:
Mailing address:
  • Phone: 561-501-5260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JASON ROMANO
Title or Position: DIRECTOR OF BILLING
Credential:
Phone: 561-565-5628