Provider Demographics
NPI:1679309561
Name:FREEDOM BEHAVIORAL HEALTH - KILLEEN PLLC
Entity type:Organization
Organization Name:FREEDOM BEHAVIORAL HEALTH - KILLEEN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEMETSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-405-9458
Mailing Address - Street 1:809 S W S YOUNG DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76543-4801
Mailing Address - Country:US
Mailing Address - Phone:254-226-3090
Mailing Address - Fax:888-595-2540
Practice Address - Street 1:809 S W S YOUNG DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-4801
Practice Address - Country:US
Practice Address - Phone:254-226-3090
Practice Address - Fax:888-595-2540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-09
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty