FREEDOM CO-OP NPI 1598042962

NPI Information

  • NPI: 1598042962
  • Provider Name: FREEDOM CO-OP
  • Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
  • Entity Type: Organization
  • Address: 1633 MADISON AVE
    MEMPHIS, TN
    ZIP 38104
  • Phone: (901) 726-6404

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NPI Details

FREEDOM CO-OP is a community based residential treatment facility, intellectual and/or developmental disabilities in Memphis, TN. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. FREEDOM CO-OP NPI is 1598042962. The provider is registered as an organization entity type.

The provider's business location address is:

1633 MADISON AVE
MEMPHIS, TN
ZIP 38104-506
Phone: (901) 726-6404

The provider's authorized official is Tom Nunnikhoven .
The authorized official title is Board Chair and has the following contact phone number (901) 833-9744.

The enumeration date for this NPI number is 11/13/2011 and was last updated on 11/13/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesL000000009711TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1G29MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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