Freedom Customized Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

FREEDOM CUSTOMIZED CARE LLC

Practice address

6614 W Florissant Ave
Unit 3a
Jennings, MO 63136-3646

Phone

(314) 494-1560

NPI assigned

Jul 21, 2014

Last updated

Jul 21, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Danita Ellen Knuckles

Title

Owner

Phone

(314) 494-1560

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405900800000",
    "number": "1689081739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6614 W FLORISSANT AVE",
            "address_2": "UNIT 3A",
            "city": "JENNINGS",
            "state": "MO",
            "postal_code": "631363646",
            "telephone_number": "314-494-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6614 W FLORISSANT AVE",
            "address_2": "UNIT 3A",
            "city": "JENNINGS",
            "state": "MO",
            "postal_code": "631363646",
            "telephone_number": "314-494-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM CUSTOMIZED CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-21",
        "last_updated": "2014-07-21",
        "status": "A",
        "authorized_official_last_name": "KNUCKLES",
        "authorized_official_first_name": "DANITA",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-494-1560",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; 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.