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FRESH START INC. NPI 1235175480


NPI Information

NPI: 1235175480
Provider Name: FRESH START, INC.
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
2415 E 55TH ST
CLEVELAND, OH
ZIP 44104
Phone: (216) 431-2554
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FRESH START, INC. is a substance abuse rehabilitation facility in Cleveland, OH. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. FRESH START, INC. NPI is 1235175480. The provider is registered as an organization entity type.

The provider's business location address is:

2415 E 55TH ST
CLEVELAND, OH
ZIP 44104-501
Phone: (216) 431-2554
Fax: (216) 431-4878

The provider's authorized official is Ruby J Black .
The authorized official title is Chief Operating Officer and has the following contact phone number (216) 431-2554.

The enumeration date for this NPI number is 6/22/2006 and was last updated on 8/22/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1324500000XSubstance Abuse Rehabilitation Facility06955OHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
107158MEDICAIDOHIO

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: 4/28/2024

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