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General NPI Number Information
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NPI Number | 1689130338
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Entity Type | Organization
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Legal Business Name | FREEDOM BEHAVIORAL HOSPITAL OF CENTRAL ARKANSAS LLC
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Dates
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Enumeration Date | 02/19/2019
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Last Update Date | 08/10/2020
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Provider Practice Location Address
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Address Line | 1400 BRADEN ST
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City | JACKSONVILLE
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State | AR
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Zip | 72076-3721
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Country | US
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Telephone | 501-985-7084
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Fax | 501-985-7085
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Provider Business Mailing Address
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Address Line | PO BOX 7935
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City | LAKE CHARLES
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State | LA
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Zip | 70606-7935
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Country | US
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Telephone | 501-985-7084
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Fax | 501-985-7085
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Authorized Official
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Title or Position | CEO
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Name | MR. TIMOTHY JASON REED
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Credential |
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Telephone | 337-802-1336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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