INEZ GWENDOLYN FREEMAN, ROBERT LEE FREEMAN (NPI# 1205243607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205243607 |
| Entity Type | Organization |
| Organization Name | INEZ GWENDOLYN FREEMAN, ROBERT LEE FREEMAN |
| Other Organization Name | INEZ GWENDOLYN FREEMAN |
| Practice Address |
1771 Halfmoon St Nw Palm Bay FL 32907-9220 |
| Practice Telephone | 3219563190 |
| Mailing Telephone | 3219563190 |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2014-07-17 |
| Authorized Official Name | MISS INEZ GWENDOLYN FREEMAN (OWNER) |
| Authorized Official Telephone | 3219563190 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
6906248 | FL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Inez Gwendolyn Freeman | Doing Business As Name - Organization |
| Street Address |
1771 HALFMOON ST NW |
| City | PALM BAY |
| State | FL |
| Zip Code | 32907-9220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861015109 | Tyreak Albert Mclarty | Behavior Technician | 2180 Julian Ave Nw, Palm Bay, FL 32907 | 2020-05-21 |
| 1871073759 | Jessica Elizabeth Ford | Physical Therapist | 470 Malabar Rd Se Unit 102, Palm Bay, FL 32907 | 2018-08-20 |
| 1598264558 | Corey Williams | Case Management | 1850 Delki St. Nw, Palm Bay, FL 32907 | 2018-02-06 |
| 1386154904 | Lauren Nicole Meek | Social Worker | 550 Malabar Rd Sw Apt 202, Palm Bay, FL 32907 | 2017-10-10 |
| 1679002877 | Kandice Monique Hearns | Physical Therapy Assistant | 175 Ne Villa Nueva Ave, Palm Bay, FL 32907 | 2017-06-09 |
| 1780113076 | Caring Manor LLC | Assisted Living Facility | 1863 Edith St Ne, Palm Bay, FL 32907 | 2017-06-08 |
| 1467992107 | Enrique Martinez | Counselor | 1510 Studley Dr. Nw, Palm Bay, FL 32907 | 2017-02-28 |
| 1144776469 | Stephanie Ann Hoenig | Physical Therapy Assistant | 1155 Malabar Rd Se, Palm Bay, FL 32907 | 2016-08-28 |
| 1124471529 | K & S Tender Care 11 | Assisted Living Facility | 226 Abalone Road Ne, Palm Bay, FL 32907 | 2016-07-20 |
| 1235507781 | Jai Ho LLC | Specialist | 1663 Georgia Street, Suite 400, Palm Bay, FL 32907 | 2015-09-14 |
| Find all providers in zip 32907 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487118584 | Marie Hamid | Custodial Care Facility | 136 Deauville Ave Ne, Palm Bay, FL 32907-3031 | 2019-01-23 |
| 1487122248 | Lakenya Jacobs | Custodial Care Facility | 937 Commerce Rd Se, Palm Bay, FL 32909-4732 | 2018-11-08 |
| 1215426598 | Cheryl C Liburd | Custodial Care Facility | 898 Fairhaven St Ne, Palm Bay, FL 32907-3270 | 2018-05-02 |
| 1396282489 | No Better Place | Custodial Care Facility | 840 Damask St Ne, Palm Bay, FL 32905-5711 | 2017-01-26 |
| 1366895195 | Lewis Adult Family Care Home | Custodial Care Facility | 149 Hagerstown St Sw, Palm Bay, FL 32908-7631 | 2016-07-17 |
| 1205242864 | Elizabeth Ann Marie Taylor | Custodial Care Facility | 1474 Meadowbrook Rd Ne, Palm Bay, FL 32905-5007 | 2014-07-03 |
| 1992116149 | Evena Jean Charles | Custodial Care Facility | 1551 Dozier Cir Se, Palm Bay, FL 32909-6535 | 2014-05-09 |
| 1073944906 | Kalaisha Brown | Custodial Care Facility | 861 Gena Rd Sw, Palm Bay, FL 32908-1739 | 2013-12-03 |
| 1528495868 | Joycie M Johnson | Custodial Care Facility | 2698 Hester Ave Se, Same, Palm Bay, FL 32909-7607 | 2013-10-01 |
| 1871836908 | Adult Family Home Care, Inc. | Custodial Care Facility | 2052 Syracuse Ct Ne, Palm Bay, FL 32905-3923 | 2013-03-27 |
| Find all providers in PALM BAY | ||||
Please comment or provide details below to improve the information on INEZ GWENDOLYN FREEMAN, ROBERT LEE FREEMAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.