New Freedom Recovery House, LLC.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

NEW FREEDOM RECOVERY HOUSE, LLC.

Practice address

1806 Boardwalk Ave
Prescott, AZ 86301-5519

Phone

(928) 379-0075

NPI assigned

Jun 22, 2011

Organization subpart

No

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

Authorized official

Name

Ryan W Jeske

Title

Owner

Phone

(928) 379-0075

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312243200000",
    "number": "1164718656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2704",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863022704",
            "telephone_number": "928-379-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 BOARDWALK AVE",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863015519",
            "telephone_number": "928-379-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW FREEDOM RECOVERY HOUSE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-22",
        "last_updated": "2011-08-02",
        "status": "A",
        "authorized_official_last_name": "JESKE",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-379-0075"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Prescott, AZ by specialty
• Substance Abuse Rehabilitation Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; 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.