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General NPI Number Information
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NPI Number | 1962789214
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Entity Type | Organization
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Legal Business Name | FREEDOM HOUSE MINISTRIES
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Dates
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Enumeration Date | 11/14/2011
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Last Update Date | 11/14/2011
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Provider Practice Location Address
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Address Line | 7044 ANTIOCH RD
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City | MERRIAM
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State | KS
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Zip | 66204-1246
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Country | US
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Telephone | 913-262-8885
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4073
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City | OVERLAND PARK
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State | KS
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Zip | 66204-0073
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Country | US
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Telephone | 913-262-8885
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. MARILYN THOMAS
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Credential |
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Telephone | 913-262-8885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 0061525002
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License Number State | KS
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