Provider Demographics
NPI:1225638067
Name:FREEDOM HEALTHCARE INC
Entity Type:Organization
Organization Name:FREEDOM HEALTHCARE INC
Other - Org Name:CARSON VALLEY COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER SUPPORT SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-701-9950
Mailing Address - Street 1:PO BOX 810
Mailing Address - Street 2:
Mailing Address - City:GOLD BEACH
Mailing Address - State:OR
Mailing Address - Zip Code:97444-0810
Mailing Address - Country:US
Mailing Address - Phone:541-373-8116
Mailing Address - Fax:
Practice Address - Street 1:777 HIGH ST STE 130
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2750
Practice Address - Country:US
Practice Address - Phone:458-224-8090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-30
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty