=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346139805
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FREEDOM IN CHRIST 1
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/30/2025
-----------------------------------------------------
Last Update Date | 06/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 21 BLACK WALNUT LN
-----------------------------------------------------
City | MARBLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28905-8851
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-557-4572
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 21 BLACK WALNUT LN
-----------------------------------------------------
City | MARBLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28905-8851
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-557-4572
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | JAMIE WRIGLEY
-----------------------------------------------------
Credential | NCCPSS
-----------------------------------------------------
Telephone | 828-557-4572
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 324500000X
-----------------------------------------------------
Taxonomy Name | Substance Abuse Rehabilitation Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 276400000X
-----------------------------------------------------
Taxonomy Name | Substance Use Disorder Rehabilitation Hospital Unit
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------