MEDICARE: FREEDOM SPRINGS THERAPY SERVICES LLC

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	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1477389344
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREEDOM SPRINGS THERAPY SERVICES LLC

Provider Business Mailing Address
First Line	:	5041 BROOKLYN AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64130-2532
Country	:	US
Telephone Number	:	816-775-2689
Fax Number	:

Provider Business Practice Location Address
First Line	:	5041 BROOKLYN AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64130-2532
Country	:	US
Telephone Number	:	816-775-2689
Fax Number	:

Authorized Official
Title or Position	:	OWNER/SPEECH-LANGUAGE PATHOLOGIST
Name	:	JADE SMITH
Credential	:	M.ED.,CCC-SLP
Telephone Number	:	816-775-2689

Provider Enumeration Date	:	09/09/2024
Last Update Date	:	09/09/2024

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