MEDICARE: FOUNDATIONS FOR FREEDOM, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	177F00000X	Lodging Provider
2	320800000X	Mental Illness Community Based Residential Treatment Facility
3	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1598573552
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOUNDATIONS FOR FREEDOM, INC.

Provider Business Mailing Address
First Line	:	1620 E CAPITOL DR UNIT 11908
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53211-4634
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3853 N 15TH ST APT 1
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53206-2913
Country	:	US
Telephone Number	:	414-698-4187
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. DANA WORLD-PATTERSON
Credential	:
Telephone Number	:	414-698-4187

Provider Enumeration Date	:	12/23/2024
Last Update Date	:	12/30/2024

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Directions to “FOUNDATIONS FOR FREEDOM, INC. ” Practice Location

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