| Freedom House Recovery Center, Inc. | |
|
355 S Madison Blvd Ste C1 Roxboro NC 27573-5485 | |
| (336) 599-8366 | |
| (336) 322-6168 |
| Full Name | Freedom House Recovery Center, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 355 S Madison Blvd, Roxboro, North Carolina |
| Authorized Official Name and Position | Joyce Harper (CEO) |
| Authorized Official Contact | 9199422803 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Freedom House Recovery Center, Inc. 104 New Stateside Dr Chapel Hill NC 27516-1165 Ph: (919) 942-2803 | Freedom House Recovery Center, Inc. 355 S Madison Blvd Ste C1 Roxboro NC 27573-5485 Ph: (336) 599-8366 |
| NPI Number | 1093986523 |
|---|---|
| Provider Enumeration Date | 03/12/2008 |
| Last Update Date | 04/22/2022 |
| Medicare PECOS PAC ID | 5193898229 |
|---|---|
| Medicare Enrollment ID | O20090619000344 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093986523 | NPI | - | NPPES |
| 8302253V | Medicaid | NC | |
| 8302253H | Medicaid | NC | |
| 6006409 | Medicaid | NC | |
| 8302253G | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | James G Groce |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811090566 PECOS PAC ID: 7911001425 Enrollment ID: I20070322000224 |
| Provider Name | Ronald Ray Alligood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407936800 PECOS PAC ID: 8921103854 Enrollment ID: I20090325000744 |
| Provider Name | Timeka E Harper Purcell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497210082 PECOS PAC ID: 0446653893 Enrollment ID: I20210723000517 |
| Provider Name | Charisse N Fullwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154085629 PECOS PAC ID: 9931593936 Enrollment ID: I20220308000163 |
| Provider Name | Adam Oluwaseun Jenrola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235880709 PECOS PAC ID: 5092100404 Enrollment ID: I20220322002448 |
| Provider Name | Brenda Mae Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437807427 PECOS PAC ID: 6800263773 Enrollment ID: I20221105000031 |
| Provider Name | Grace Chelangat Korir |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952035248 PECOS PAC ID: 4486019007 Enrollment ID: I20230503001216 |
| Provider Name | Nevaid Luke Nyagwande |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336892801 PECOS PAC ID: 9032577325 Enrollment ID: I20230619001115 |
| Provider Name | Jerrell Lee Mitchell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104280825 PECOS PAC ID: 8628341237 Enrollment ID: I20231219003807 |
| Provider Name | Juliana Mutindi Mutua |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689369464 PECOS PAC ID: 3173969060 Enrollment ID: I20240314000448 |
| Provider Name | Christine Elizabeth Cauwels |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851762017 PECOS PAC ID: 4284167750 Enrollment ID: I20241023002260 |
| Provider Name | Varstarr Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467630210 PECOS PAC ID: 6406202019 Enrollment ID: I20250415000658 |
Dlp Person Physician Practices, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 503 Ridge Rd, Roxboro, NC 27573 Phone: 336-503-5703 Fax: 336-322-1819 | |
Roxboro Medaccess Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3762 Durham Road, Roxboro, NC 27573 Phone: 336-330-0400 Fax: 336-330-0031 | |
Premise Health Of North Carolina Medical, P.c Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10475 Boston Rd, Roxboro, NC 27574 Phone: 336-439-5480 | |
County Of Person Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 355 S Madison Blvd Ste A, Roxboro, NC 27573 Phone: 336-597-2204 Fax: 336-597-4804 | |
Med First Immediate Care & Family Practice, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 Weeks Dr, Roxboro, NC 27573 Phone: 336-598-5480 Fax: 336-598-5482 | |
Dlp Person Urgent Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3762 Durham Rd Ste A, Roxboro, NC 27573 Phone: 336-330-0400 Fax: 336-330-0031 |