Provider Demographics
NPI:1477384568
Name:FREEDOM HOUSE RECOVERY, INC.
Entity type:Organization
Organization Name:FREEDOM HOUSE RECOVERY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTCLAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-471-8090
Mailing Address - Street 1:2501 E 28TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SIGNAL HILL
Mailing Address - State:CA
Mailing Address - Zip Code:90755-2156
Mailing Address - Country:US
Mailing Address - Phone:323-471-8090
Mailing Address - Fax:
Practice Address - Street 1:2501 E 28TH ST STE 102
Practice Address - Street 2:
Practice Address - City:SIGNAL HILL
Practice Address - State:CA
Practice Address - Zip Code:90755-2156
Practice Address - Country:US
Practice Address - Phone:323-471-8090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility