FRESH START TRANSITIONAL HOMES (NPI# 1881853968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881853968 |
| Entity Type | Organization |
| Organization Name | FRESH START TRANSITIONAL HOMES |
| Practice Address |
17839 Goddard St Detroit MI 48212-1056 |
| Mailing Address |
Po Box 503 New Baltimore MI 48047-0503 |
| Practice Telephone | 3132816208 |
| Practice Fax Number | 3132816208 |
| Mailing Telephone | 3138509220 |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2008-06-04 |
| Authorized Official Name | MRS. DENISE SMITH (PRESIDENT) |
| Authorized Official Telephone | 3138509220 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
AS820283748 | MI | Nursing & Custodial Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | FRESH START TRANSITIONAL HOMES | 5868 Jackelyn Court, Washington, MI 48094-4225 |
| Street Address |
17839 GODDARD ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48212-1056 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689193 | Mohammed Louthfur Rahman | Nurse Practitioner | Hoover Internal Medicine Pllc, 2930 Holbrook St, Hamtramck, MI 48212 | 2020-11-03 |
| 1386243178 | Hoover Internal Medicine Pllc | Internal Medicine | 4067 Georgia St, Hamtramck, MI 48212 | 2020-10-22 |
| 1013514538 | Ranim Suliman | Dentist | 9824 Conant St, Hamtramck, MI 48212 | 2020-10-07 |
| 1942770631 | Joann Harrison | Nurse Practitioner | 17941 St. Aubin Street, Detroit, MI 48212 | 2018-11-26 |
| 1134605298 | Advanced Medical Equipment Inc | Durable Medical Equipment & Medical Supplies | 9740 Conant St Ste 4, Hamtramck, MI 48212 | 2018-07-12 |
| 1477051530 | Detroit Green Carrot LLC | Foster Care Agency | 3829 Alpha, Detroit, MI 48212 | 2018-01-24 |
| 1528595451 | Mercy Prakash | Nurse Practitioner | 3120 Carpenter St. Ste 201, Adult & Pediatric Medicine Pllc, Hamtramck, MI 48212 | 2017-05-23 |
| 1033408935 | Hamtramck Pediatrics | Clinic/Center | 12033 Conant Road, Hamtramck, MI 48212 | 2011-03-31 |
| 1194051557 | Niaah Ellis | Counselor | 4812 E. Mcnichols, Detroit, MI 48212 | 2009-10-20 |
| 1912136797 | Latoya T Jackosn | Counselor | Sunshine Treatment In, 4821 E. Mcnichols, Detroit, MI 48212 | 2009-07-14 |
| Find all providers in zip 48212 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063028694 | Zcare | Custodial Care Facility | 8676 Auburn St, Detroit, MI 48228-2919 | 2020-09-18 |
| 1790397594 | St. Ruth's House of Hope LLC | Custodial Care Facility | 3100 S Electric St, Detroit, MI 48217-1133 | 2020-08-21 |
| 1558837229 | New Center Inn Company | Custodial Care Facility | 158 Pingree St, Detroit, MI 48202-2022 | 2018-10-19 |
| 1477029700 | Acon Services, Inc. | Custodial Care Facility | 17126 Prevost St, Detroit, MI 48235-3551 | 2018-10-14 |
| 1619452588 | Hudson Home 1 Inc | Custodial Care Facility | 750 Virginia Park St, Detroit, MI 48202-2033 | 2018-09-26 |
| 1578083077 | New Advantage Inc. | Custodial Care Facility | 15375 Ardmore St, Detroit, MI 48227-3222 | 2017-06-26 |
| 1003348145 | Reality Response LLC | Custodial Care Facility | 2455 W Grand St, Detroit, MI 48238-3445 | 2017-03-29 |
| 1376080614 | Crystal Serenity House | Custodial Care Facility | 14241 Faust Ave Ste 200-b, Detroit, MI 48223-3574 | 2017-01-25 |
| 1225585250 | Maan Down LLC | Custodial Care Facility | 16885 Ilene St, Detroit, MI 48221 | 2016-09-07 |
| 1881051712 | Tasha Harris | Custodial Care Facility | 6402 Penrod St, Detroit, MI 48228-4748 | 2016-01-22 |
| Find all providers in DETROIT | ||||
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| 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.