Freedom Behavioral Hospital of Central Arkansas LLC

Primary specialty

Psychiatric HospitalTaxonomy code 283Q00000X

Legal business name

FREEDOM BEHAVIORAL HOSPITAL OF CENTRAL ARKANSAS LLC

Practice address

1400 Braden St
Jacksonville, AR 72076-3721

Phone

(501) 985-7084

Fax

(501) 985-7085

NPI assigned

Feb 19, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Timothy Jason Reed

Title

Ceo

Phone

(337) 802-1336

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 044023

Legal name

FREEDOM BEHAVIORAL HOSPITAL OF CENTRAL ARKANAS LLC

Certification status

Terminated Voluntary: merger or closure, Dec 1, 2020

Provider type (POS)

Hospital – Psychiatric

Participating since

Mar 17, 2020

Last certification

Mar 17, 2020

Beds

24

Ownership / control type

Private (for profit)

Facility address

1400 Braden Street
Jacksonville, AR 72076

Locations

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597017600000",
    "number": "1689130338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7935",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706067935",
            "telephone_number": "501-985-7084",
            "fax_number": "501-985-7085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BRADEN ST",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720763721",
            "telephone_number": "501-985-7084",
            "fax_number": "501-985-7085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM BEHAVIORAL HOSPITAL OF CENTRAL ARKANSAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-19",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-802-1336",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann Fowler, LPC
• Mary Lu Fowler
• Marandy Renee Franklin, LPN
• Angelyn Franks, M.S. CCC-SLP
• Destiny Yvonne Frazier
• Ryan Barrett Friedman, M.D.
• Alexandria Noelle Fuchsberger
• Allison Elizabeth Fullen, LCSW
• Rhonda Rachelle Fuller
• Tjyunna Fuller

• Psychiatric Hospital in Jacksonville, AR
• Providers in Jacksonville, AR by specialty
• Psychiatric Hospital in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.