Healthcare Provider Details

I. General information

NPI: 1548490378
Provider Name (Legal Business Name): FREEDOM HOUSE RECOVERY CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2009
Last Update Date: 06/24/2021
Certification Date: 06/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 NEW STATESIDE DR
CHAPEL HILL NC
27516
US

IV. Provider business mailing address

104 NEW STATESIDE DR
CHAPEL HILL NC
27516-1165
US

V. Phone/Fax

Practice location:
  • Phone: 919-967-8844
  • Fax: 919-929-0601
Mailing address:
  • Phone: 919-942-2803
  • Fax: 919-942-2126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberMHL-068-118
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License NumberMHL-068-118
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License NumberMHL-068-118
License Number StateNC

VIII. Authorized Official

Name: JOYCE HARPER
Title or Position: CEO
Credential:
Phone: 919-942-2803