1598842866 NPI number — FREEDOM INTERACTION

Table of content: (NPI 1598842866)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598842866 NPI number — FREEDOM INTERACTION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FREEDOM INTERACTION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ATTENTION LEARNING CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598842866
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7065 W ANN RD
Provider Second Line Business Mailing Address:
#130-300
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89130-3865
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-396-0101
Provider Business Mailing Address Fax Number:
702-222-0212

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2251 S JONES BLVD
Provider Second Line Business Practice Location Address:
SUITE 121
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89146-3164
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-396-0101
Provider Business Practice Location Address Fax Number:
702-222-0212
Provider Enumeration Date:
11/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
AGAMEZ
Authorized Official First Name:
MONA
Authorized Official Middle Name:
HIBBERT
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
702-393-0101

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  0470 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 225XP0200X , with the licence number: 0470 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)





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