Provider Demographics
NPI:1790447274
Name:FREEDOM MANAGEMENT
Entity Type:Organization
Organization Name:FREEDOM MANAGEMENT
Other - Org Name:S.P.A.R.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-681-2490
Mailing Address - Street 1:PO BOX 571
Mailing Address - Street 2:
Mailing Address - City:RUSSELL SPRINGS
Mailing Address - State:KY
Mailing Address - Zip Code:42642-0571
Mailing Address - Country:US
Mailing Address - Phone:502-681-2490
Mailing Address - Fax:
Practice Address - Street 1:50 LUDA ST
Practice Address - Street 2:
Practice Address - City:RUSSELL SPRINGS
Practice Address - State:KY
Practice Address - Zip Code:42642-4512
Practice Address - Country:US
Practice Address - Phone:270-858-5377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-12
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health