Provider Demographics
NPI:1972070365
Name:FREEDOM THROUGH EDUCATION CAMPUS
Entity Type:Organization
Organization Name:FREEDOM THROUGH EDUCATION CAMPUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ERNEST
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:916-216-5721
Mailing Address - Street 1:PO BOX 60995
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95860-0995
Mailing Address - Country:US
Mailing Address - Phone:916-217-5721
Mailing Address - Fax:916-840-5911
Practice Address - Street 1:3281 35TH AVE STE 2&4
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95824-1068
Practice Address - Country:US
Practice Address - Phone:916-701-5113
Practice Address - Fax:916-840-5911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty