Organization
NEW FREEDOM RECOVERY HOUSE, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN W JESKE (OWNER)
(928) 379-0075
Entity
Organization
Contact information
Practice address
1806 BOARDWALK AVE, PRESCOTT, AZ 86301-5519
(928) 379-0075
Mailing address
PO BOX 2704, PRESCOTT, AZ 86302-2704
(928) 379-0075
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/22/2011
Last updated
08/02/2011
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