Freedom Villa Inc

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

AS630299536 Issued in MI

Legal business name

FREEDOM VILLA INC

Practice address

3509 Elizabeth Lake Rd Ste 102
Waterford, MI 48328-3003

Phone

(248) 681-3658

Fax

(248) 681-3658

NPI assigned

May 16, 2017

Organization subpart

No

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

Authorized official

Name

Ms. Olayemi Sanni, RNNPI 1275136178

Title

Administrative Director

Phone

(248) 895-7028

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Olayemi Olayinka Sanni, DNP

  • Acute Care Nurse Practitioner
  • West Bloomfield, MI
  • NPI 1275136178
  NPD Authorized official

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

{
    "created_epoch": "1494892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1497282800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 ELIZABETH LAKE RD STE 102",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283003",
            "telephone_number": "248-681-3658",
            "fax_number": "248-681-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 ELIZABETH LAKE RD STE 102",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283003",
            "telephone_number": "248-681-3658",
            "fax_number": "248-681-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM VILLA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-16",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SANNI",
        "authorized_official_first_name": "OLAYEMI",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "248-895-7028",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "MI",
            "license": "AS630299536",
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "MI",
            "license": "AS630377897",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carl Fowler, MD
• Fox Manor, Inc. (Fox Manor)
• Brianna Lynn Fox
• Freedom House Resource Center
• Freedom House Resource Center Inc
• Coleman Luis Fresquez
• Jennifer Lynn Frey
• Ingrid Vaara Fuderer
• Fugle and Associates, PC
• Kelly Fulks

• Mental Illness Community Based Residential Treatment Facility in Waterford, MI
• Providers in Waterford, MI by specialty
• Mental Illness Community Based Residential Treatment Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.