MEDICARE: FREEDOM UNLIMITED NOW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1306262316
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREEDOM UNLIMITED NOW

Provider Business Mailing Address
First Line	:	2825 BEACH BLVD S
Second Line	:
City	:	GULFPORT
State	:	FL
Zip	:	33707-5535
Country	:	US
Telephone Number	:	727-599-4673
Fax Number	:

Provider Business Practice Location Address
First Line	:	2825 BEACH BLVD S
Second Line	:
City	:	GULFPORT
State	:	FL
Zip	:	33707-5535
Country	:	US
Telephone Number	:	727-599-4673
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. KIM R COSTANZO
Credential	:
Telephone Number	:	954-551-7730

Provider Enumeration Date	:	03/14/2014
Last Update Date	:	03/14/2014

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