Organization
FREEDOM YOUTH PROGRAM
Active
Other names
Freedom Youth Program
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ZARELL ZACKITOUS PATTON (CHIEF EXECUTIVE OFFICER)
(216) 230-2005
Entity
Organization
Contact information
Practice address
1421 EAST 174TH STREET, CLEVELAND, OH 44110-2934
(216) 230-2005
Mailing address
1421 EAST 174TH STREET, CLEVELAND, OH 44110-2934
(216) 230-2005
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/16/2021
Last updated
04/19/2022
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