NPIMap

Organization Active NPI

Freedom Healthcare, LLC

Doing business as Community Wellness PRP

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
National Provider Identifier
1487106472
Registry record updated Oct 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
FREEDOM HEALTHCARE, LLC
Doing business as
Community Wellness PRP
Practice address
3310 Eastern Ave
Baltimore, MD 21224-4108
Phone
(202) 651-1857
NPI assigned
Oct 26, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2016

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

Authorized official

Name
Vernon Holmes Jr., MBA
Title
Chief Executive Officer
Phone
(202) 651-1857

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X MD Primary

Addresses

Primary practice location

3310 Eastern Ave
Baltimore, MD 21224-4108

Mailing address

3310 Eastern Ave
Baltimore, MD 21224-4108
Phone (202) 651-1857

Other names 1

  • Community Wellness PRP Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Freedom Healthcare LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1477440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477440000000",
    "number": "1487106472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 EASTERN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212244108",
            "telephone_number": "202-651-1857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 EASTERN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212244108",
            "telephone_number": "202-651-1857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-26",
        "last_updated": "2016-10-26",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "VERNON",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "202-651-1857",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Wellness PRP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; 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.