Healthcare Provider Details

I. General information

NPI: 1356974935
Provider Name (Legal Business Name): FREEMAN ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2020
Last Update Date: 02/21/2020
Certification Date: 02/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

367 MAIN ST. LAUREL
LAUREL MD
20707-2070
US

IV. Provider business mailing address

7113 LITTLE COVE FARM LAUREL
ELKRIDGE MD
21075
US

V. Phone/Fax

Practice location:
  • Phone: 301-604-4000
  • Fax:
Mailing address:
  • Phone: 678-662-8827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERNEST FREEMAN
Title or Position: OWNER
Credential:
Phone: 678-662-8827