Provider Demographics
NPI:1225366404
Name:FREEMAN ENRICHMENT CENTER INC
Entity Type:Organization
Organization Name:FREEMAN ENRICHMENT CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF BOARD
Authorized Official - Prefix:DR
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:JEFFERSON
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-763-1660
Mailing Address - Street 1:PO BOX 11146
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90749-1146
Mailing Address - Country:US
Mailing Address - Phone:310-763-1660
Mailing Address - Fax:310-886-3258
Practice Address - Street 1:3013 BLUSH NOISETTE AVE
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-6443
Practice Address - Country:US
Practice Address - Phone:702-767-4654
Practice Address - Fax:310-886-3258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency