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General NPI Number Information
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NPI Number | 1841927787
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Entity Type | Organization
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Legal Business Name | FREEDOM BY FAITH, LLC
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Dates
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Enumeration Date | 08/02/2022
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Last Update Date | 08/02/2022
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Provider Practice Location Address
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Address Line | 46670 CLAXTON DR
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City | BELLEVILLE
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State | MI
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Zip | 48111-8677
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Country | US
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Telephone | 313-721-0101
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Fax |
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Provider Business Mailing Address
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Address Line | 46670 CLAXTON DR
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City | BELLEVILLE
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State | MI
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Zip | 48111-8677
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Country | US
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Telephone | 313-721-0101
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. SHELBY LYNN GARDUNO
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Credential | BSN, RN, CCM
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Telephone | 313-721-0101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374K00000X
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Taxonomy Name | Religious Nonmedical Practitioner
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License Number |
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License Number State |
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