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General NPI Number Information
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NPI Number | 1326791500
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Entity Type | Organization
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Legal Business Name | ENCOUNTER FREEDOM SERVICES LLC
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Dates
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Enumeration Date | 01/28/2022
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Last Update Date | 01/28/2022
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Provider Practice Location Address
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Address Line | 6611 E CENTRAL AVE STE C
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City | WICHITA
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State | KS
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Zip | 67206-1937
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Country | US
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Telephone | 316-402-1414
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Fax | 316-358-7713
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Provider Business Mailing Address
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Address Line | 6611 E CENTRAL AVE STE C
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City | WICHITA
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State | KS
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Zip | 67206-1937
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Country | US
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Telephone | 316-258-4102
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Fax | 316-358-7713
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JAMAAL JONES
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Credential | LSCSW
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Telephone | 316-258-4102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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