Organization
NEW FREEDOM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENIS W VINYARD BS MDIV CADC1 (DIRECTOR)
(913) 367-0411
Entity
Organization
Contact information
Practice address
1600 SKYWAY, ATCHISON, KS 66002
(913) 367-0411
(913) 367-1517
Mailing address
PO BOX 18, 1600 SKYWAY, ATCHISON, KS 66002
(913) 367-0411
(913) 367-1517
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
185
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10001620400
COMMUNITY HEALTH PLAN
—
01
—
314150
HMS VALUE OPTIONS
—
Enumeration date
10/03/2006
Last updated
08/22/2020
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