Provider Demographics
NPI:1962816900
Name:FREEDOM HOUSE RECOVERY CENTER, INC.
Entity Type:Organization
Organization Name:FREEDOM HOUSE RECOVERY CENTER, INC.
Other - Org Name:NEW DIRECTIONS AT LONG MILL
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-942-2803
Mailing Address - Street 1:104 NEW STATESIDE DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-1165
Mailing Address - Country:US
Mailing Address - Phone:919-942-2803
Mailing Address - Fax:919-942-2126
Practice Address - Street 1:1753 LONG MILL RD
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27596-7469
Practice Address - Country:US
Practice Address - Phone:919-554-0667
Practice Address - Fax:919-554-1765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-18
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-035-066251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health