Healthcare Provider Details

I. General information

NPI: 1962789214
Provider Name (Legal Business Name): FREEDOM HOUSE MINISTRIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2011
Last Update Date: 11/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7044 ANTIOCH RD
MERRIAM KS
66204-1246
US

IV. Provider business mailing address

PO BOX 4073
OVERLAND PARK KS
66204-0073
US

V. Phone/Fax

Practice location:
  • Phone: 913-262-8885
  • Fax:
Mailing address:
  • Phone: 913-262-8885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number0061525002
License Number StateKS

VIII. Authorized Official

Name: MRS. MARILYN THOMAS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 913-262-8885