Provider Demographics
NPI:1043753262
Name:FREEDOM THERAPY CENTER, LLC
Entity Type:Organization
Organization Name:FREEDOM THERAPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:D
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:318-613-0147
Mailing Address - Street 1:1102 TEXAS AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-4835
Mailing Address - Country:US
Mailing Address - Phone:318-613-0147
Mailing Address - Fax:
Practice Address - Street 1:1102 TEXAS AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-4835
Practice Address - Country:US
Practice Address - Phone:318-613-0147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-19
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health