Healthcare Provider Details

I. General information

NPI: 1518891308
Provider Name (Legal Business Name): FRREDOMCARE OF MISSISSIPPI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 E CAPITOL ST STE 201
JACKSON MS
39201-3409
US

IV. Provider business mailing address

317 E CAPITOL ST STE 201
JACKSON MS
39201-3409
US

V. Phone/Fax

Practice location:
  • Phone: 601-531-9110
  • Fax: 601-368-6819
Mailing address:
  • Phone: 601-531-9110
  • Fax: 601-368-6819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. CAITLIN GRIFFIN
Title or Position: DIRECTOR, NATIONAL EXPANSION
Credential:
Phone: 315-304-5151