FRESH START RESIDENTIAL SERVICES INC (NPI# 1669507315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669507315 |
| Entity Type | Organization |
| Organization Name | FRESH START RESIDENTIAL SERVICES INC |
| Practice Address |
5817 Old Forge Cir Raleigh NC 27609-4035 |
| Mailing Address |
2411 E Millbrook Rd Ste 114 Raleigh NC 27604-2800 |
| Practice Telephone | 9197907869 |
| Practice Fax Number | 9197907864 |
| Mailing Telephone | 9197907869 |
| Mailing Fax Number | 9197907864 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2008-06-19 |
| Authorized Official Name | MR. MICHAEL PARKS (PRESIDENT) |
| Authorized Official Telephone | 9197907869 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | MHL 092 480 | NC | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336274083 | Fresh Start Residential Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 3833 Buffaloe Rd, Raleigh, NC 27604-4210 | 2007-02-22 |
| 1851426431 | Fresh Start Residential Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 4928 Coolridge Ct Apt A, Raleigh, NC 27616-5294 | 2007-02-22 |
| 1255466827 | Fresh Start Residential Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 5039 Sedgewick Dr Apt D, Raleigh, NC 27616-4576 | 2007-02-22 |
| 1760547590 | Fresh Start Residential Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2411 E Millbrook Rd, Suite 114, Raleigh, NC 27604-2800 | 2006-12-22 |
| Street Address |
5817 OLD FORGE CIR |
| City | RALEIGH |
| State | NC |
| Zip Code | 27609-4035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184235582 | Choice Service Solutions LLC | In Home Supportive Care | 5300 Six Fox Rd Siite205, Raleigh, NC 27609 | 2020-08-11 |
| 1003426073 | Rosana Oba -rovira | Registered Nurse | 5300 Six Fox Road, Suite 205, Raleigh, NC 27609 | 2020-08-05 |
| 1821612706 | Helen Alexandra Bonner | Physical Medicine & Rehabilitation | Hey Clinic Pa, 3320 Wake Forest Road Ste 450, Raleigh, NC 27609 | 2020-06-05 |
| 1215423579 | Appiah Nana Larbi | Social Worker | Easter Seals Ucp 4000 Wake Forest Rd Ste 200, Raleigh, NC 27609 | 2018-07-10 |
| 1215423777 | Broadway Home Care LLC | In Home Supportive Care | 107 Windel Dr Ste 105, Raleigh, NC 27609 | 2018-07-09 |
| 1275027948 | Lacey Allene Cottingham | Social Worker | 312 W Millbrook Rd Ste 129, Raleigh, NC 27609 | 2018-06-18 |
| 1447748819 | Integrated Dermatology of North Raleigh, Pllc | Dermatology | 3809 Computer Dr Ste 200, Raleigh, NC 27609 | 2018-05-01 |
| 1902325418 | Naomi Christine Askew | Nurse Practitioner | 3400 Wake Forest Drive, Bldg 9, Bldg #9, 4th Floor, Raleigh, NC 27609 | 2017-09-15 |
| 1962929679 | Alexia Montague | Social Worker | 1306 Paddock Drive Suite E-100, Raleigh, NC 27609 | 2017-08-23 |
| 1730602236 | Chantel Washington-mbuthia | Counselor | 1100 Logger Ct. Ste C100, Heartfelt Alternative Inc, Raleigh, NC 27609 | 2017-07-18 |
| Find all providers in zip 27609 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598133209 | S.t.e.p. Up Behavioral Services, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 5809 N Beaver Ln, Raleigh, NC 27604-6057 | 2015-09-11 |
| 1033358825 | Chance Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1305 Hendren Cir, Raleigh, NC 27610-4937 | 2009-02-18 |
| 1386805984 | Carrington Children Family Services, L.l.c | Residential Treatment Facility, Emotionally Disturbed Children | 4401 Goldcrest Ln, Raleigh, NC 27616-8816 | 2008-06-17 |
| 1003005240 | Phyd, Inc. (pretty Homes Youth Development) | Residential Treatment Facility, Emotionally Disturbed Children | 1611 Poole Rd, Raleigh, NC 27610-2658 | 2007-10-23 |
| 1043409113 | Hope Services, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 8909 Sauls Rd, Raleigh, NC 27603-8726 | 2007-10-15 |
| 1992918627 | 2nd Chance Home for Children | Residential Treatment Facility, Emotionally Disturbed Children | 729 Kavkaz St, Raleigh, NC 27610-3174 | 2007-05-08 |
| 1639205701 | Gill House | Residential Treatment Facility, Emotionally Disturbed Children | 845 Cross Link Rd, Raleigh, NC 27610-4730 | 2007-02-26 |
| 1336274083 | Fresh Start Residential Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 3833 Buffaloe Rd, Raleigh, NC 27604-4210 | 2007-02-22 |
| 1851426431 | Fresh Start Residential Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 4928 Coolridge Ct Apt A, Raleigh, NC 27616-5294 | 2007-02-22 |
| 1255466827 | Fresh Start Residential Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 5039 Sedgewick Dr Apt D, Raleigh, NC 27616-4576 | 2007-02-22 |
| Find all providers in RALEIGH | ||||
Please comment or provide details below to improve the information on FRESH START RESIDENTIAL SERVICES INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.