Provider Demographics
NPI:1679052096
Name:FREYA ENTERPRISE LLC
Entity Type:Organization
Organization Name:FREYA ENTERPRISE LLC
Other - Org Name:CEDAR BROOK ACRES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:NORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-932-3363
Mailing Address - Street 1:8153 TOLLBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-1692
Mailing Address - Country:US
Mailing Address - Phone:513-623-9825
Mailing Address - Fax:
Practice Address - Street 1:673 STUBBS MILL RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-9629
Practice Address - Country:US
Practice Address - Phone:513-932-3363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FREYA ENTERPRISE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1679944714Medicaid