NPIMap

Organization Active NPI

Freedom Manor, Inc.

  • Lodging Provider
  • Mesa, AZ
National Provider Identifier
1194888073
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lodging ProviderTaxonomy code 177F00000X
License
ALH-4155 Issued in AZ
Legal business name
FREEDOM MANOR, INC.
Practice address
628 E Knoll St
Mesa, AZ 85203-1807
Phone
(602) 956-5556
Fax
(602) 957-6556
NPI assigned
Dec 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Sharon L. Phillips
Title
Owner
Phone
(602) 956-5556

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lodging ProviderGroup: 193400000X SINGLE SPECIALTY GROUP 177F00000X ALH-4155 AZ Primary

Addresses

Primary practice location

628 E Knoll St
Mesa, AZ 85203-1807

Mailing address

2524 E Heatherbrae Dr
Phoenix, AZ 85016-5668
Phone (602) 956-5556

Other identifiers 1

IdentifierTypeStateIssuer
755126OtherAZPROVIDER ID

Other names 1

  • Freedom Manor - Trethewey House Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Freedom Manor - Bandalier House7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194888073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2524 E HEATHERBRAE DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165668",
            "telephone_number": "602-956-5556",
            "fax_number": "602-957-6556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 E KNOLL ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852031807",
            "telephone_number": "602-956-5556",
            "fax_number": "602-957-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM MANOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-956-5556",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "177F00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Lodging",
            "state": "AZ",
            "license": "ALH-4155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER ID",
            "identifier": "755126",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Freedom Manor - Trethewey House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.