Healthcare Provider Details

I. General information

NPI: 1447029376
Provider Name (Legal Business Name): FREEDOM THROUGH RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2023
Last Update Date: 12/20/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 38TH AVE S STE F
FARGO ND
58104-7749
US

IV. Provider business mailing address

PO BOX 397
CASSELTON ND
58012-0397
US

V. Phone/Fax

Practice location:
  • Phone: 701-388-8144
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ELISHA HOYE
Title or Position: CFO
Credential:
Phone: 701-388-8144