FRESH START RECOVERY CENTER LLC NPI 1144809088

NPI Information

NPI: 1144809088
Provider Name: FRESH START RECOVERY CENTER LLC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
15886 GAITHER DR STE B
GAITHERSBURG, MD
ZIP 20877
Phone: (844) 814-6862
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FRESH START RECOVERY CENTER LLC is a mental health (including community mental health center) clinic center in Gaithersburg, MD. FRESH START RECOVERY CENTER LLC NPI is 1144809088. The provider is registered as an organization entity type.

The provider's business location address is:

15886 GAITHER DR STE B
GAITHERSBURG, MD
ZIP 20877-404
Phone: (844) 814-6862

The provider's authorized official is Jessie Costley .
The authorized official title is Licensing Specialist and has the following contact phone number (410) 807-8471.

The enumeration date for this NPI number is 4/7/2021 and was last updated on 4/7/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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