| Fresh Start Community Services Llc | |
|
2470 Pruden Blvd Suffolk VA 23434-4206 | |
| (757) 934-3399 | |
| (757) 934-3389 |
| Full Name | Fresh Start Community Services Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2470 Pruden Blvd, Suffolk, Virginia |
| Authorized Official Name and Position | Vesha Jones (CEO/PRESIDENT) |
| Authorized Official Contact | 7572020295 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fresh Start Community Services Llc 127 Highfield Rd Suffolk VA 23434-9316 Ph: (757) 202-0295 | Fresh Start Community Services Llc 2470 Pruden Blvd Suffolk VA 23434-4206 Ph: (757) 934-3399 |
| NPI Number | 1386474997 |
|---|---|
| Provider Enumeration Date | 08/07/2024 |
| Last Update Date | 08/13/2024 |
| Certification Date | 08/13/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386474997 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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