MEDICARE: FREEDOM IN CHOICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	LCPC-5839	ID

General Provider Information

NPI Number	:	1972973089
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREEDOM IN CHOICES LLC

Provider Business Mailing Address
First Line	:	1235 FILER AVE E
Second Line	:
City	:	TWIN FALLS
State	:	ID
Zip	:	83301-4118
Country	:	US
Telephone Number	:	208-595-2490
Fax Number	:

Provider Business Practice Location Address
First Line	:	1235 FILER AVE E
Second Line	:
City	:	TWIN FALLS
State	:	ID
Zip	:	83301-4118
Country	:	US
Telephone Number	:	208-595-2490
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. TERRI L VOYLES
Credential	:	BS CPRP CADC
Telephone Number	:	208-595-2490

Provider Enumeration Date	:	10/01/2015
Last Update Date	:	08/02/2016

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Directions to “FREEDOM IN CHOICES LLC ” Practice Location

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