Provider Demographics
NPI:1215284203
Name:FREEDOM HOUSE RESOURCE CENTER
Entity type:Organization
Organization Name:FREEDOM HOUSE RESOURCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO FOUNDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARLENA
Authorized Official - Middle Name:PATRICE
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:CPEC
Authorized Official - Phone:888-458-7995
Mailing Address - Street 1:419 BLOEDEL RESERVE WAY
Mailing Address - Street 2:101
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907
Mailing Address - Country:US
Mailing Address - Phone:888-458-7995
Mailing Address - Fax:
Practice Address - Street 1:7080 ROLLING HILLS DR
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48327-4156
Practice Address - Country:US
Practice Address - Phone:888-458-7995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-08
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management