Healthcare Provider Details

I. General information

NPI: 1871196709
Provider Name (Legal Business Name): FREEDOM FAMILY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2020
Last Update Date: 11/22/2020
Certification Date: 11/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 SAVIN COURT
VIRGINIA BEACH VA
23455
US

IV. Provider business mailing address

9357 BEACH VIEW ST
NORFOLK VA
23503-3000
US

V. Phone/Fax

Practice location:
  • Phone: 757-621-4953
  • Fax:
Mailing address:
  • Phone: 757-621-4953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY HANSEN REISINGER
Title or Position: OWNER/MANAGER
Credential: M.A., BCBA, LBA
Phone: 757-621-4953