Freedom Recovery Center, LLC.

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

BH4228 Issued in AZ

Legal business name

FREEDOM RECOVERY CENTER, LLC.

Practice address

1470 W Gurley St
Prescott, AZ 86305-2855

Phone

(928) 379-0075

Fax

(855) 379-3977

NPI assigned

Apr 15, 2013

Last updated

Apr 15, 2013By 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

Ryan W Jeske

Title

Ceo

Phone

(928) 379-0075

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1365984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365984000000",
    "number": "1528401072",
    "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",
            "fax_number": "855-379-3977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 W GURLEY ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863052855",
            "telephone_number": "928-379-0075",
            "fax_number": "855-379-3977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM RECOVERY CENTER, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-15",
        "last_updated": "2013-04-15",
        "status": "A",
        "authorized_official_last_name": "JESKE",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "928-379-0075"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "AZ",
            "license": "BH4228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fred S Markham MD PC
• Jean Jauner Frederic, NP
• Tracey Frederiksen, MC
• Zoey L Freebairn, NMD
• Freedom Performance, LLC
• Austin Freeman, PHARMD
• Laurel Freeman, RN
• Michael Adrian Frost, FNP, RN
• Tammy Frost, PA-C
• Linda Scruggs Fry

• Substance Use Disorder Rehabilitation Clinic/Center in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; 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.