Healthcare Provider Details

I. General information

NPI: 1720918204
Provider Name (Legal Business Name): FREEDOM HHC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9191 R G SKINNER PKWY UNIT 605
JACKSONVILLE FL
32256-9661
US

IV. Provider business mailing address

6422 GREEN MYRTLE DR
JACKSONVILLE FL
32258-3144
US

V. Phone/Fax

Practice location:
  • Phone: 904-687-2412
  • Fax: 904-683-5095
Mailing address:
  • Phone: 904-687-2412
  • Fax: 904-683-5095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MRS. OLIVIA BERGUS
Title or Position: ADMINISTRATOR
Credential:
Phone: 508-769-2707