Organization
FREEDOM RECOVERY CENTER, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN W JESKE (CEO)
(928) 379-0075
Entity
Organization
Contact information
Practice address
1470 W GURLEY ST, PRESCOTT, AZ 86305-2855
(928) 379-0075
(855) 379-3977
Mailing address
PO BOX 2704, PRESCOTT, AZ 86302-2704
(928) 379-0075
(855) 379-3977
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
BH4228
AZ
Other
Enumeration date
04/15/2013
Last updated
04/15/2013
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