Provider Demographics
NPI:1154851814
Name:FREEDOM SERVICES - LWT L.L.C.
Entity type:Organization
Organization Name:FREEDOM SERVICES - LWT L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-596-8580
Mailing Address - Street 1:A HENSYN VLG APT 8B
Mailing Address - Street 2:
Mailing Address - City:BUDD LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07828-3702
Mailing Address - Country:US
Mailing Address - Phone:862-596-8580
Mailing Address - Fax:
Practice Address - Street 1:A HENSYN VILLAGE 8B
Practice Address - Street 2:
Practice Address - City:BUDD LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07828-3702
Practice Address - Country:US
Practice Address - Phone:862-596-8580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health