| Fresh Start Psychiatric Clinic | |
|
11455 Fallbrook Dr Ste 201 Houston TX 77065-4267 | |
| (337) 223-9487 | |
| (888) 511-5650 |
| Full Name | Fresh Start Psychiatric Clinic |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 11455 Fallbrook Dr Ste 201, Houston, Texas |
| Authorized Official Name and Position | Matthiaus Suire (OWNER) |
| Authorized Official Contact | 5129520295 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fresh Start Psychiatric Clinic 1921 Dulles Dr Lafayette LA 70506-2716 Ph: (373) 223-9487 | Fresh Start Psychiatric Clinic 11455 Fallbrook Dr Ste 201 Houston TX 77065-4267 Ph: (337) 223-9487 |
| NPI Number | 1427666353 |
|---|---|
| Provider Enumeration Date | 07/16/2020 |
| Last Update Date | 07/16/2021 |
| Certification Date | 05/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427666353 | NPI | - | NPPES |
| 11813129 | Other | CAQH | |
| 1029807 | Medicaid | LA | |
| 600712760 | Other | LA | MAGELLAN |
| NJ2611 | Other | NJ | BCBS# |
| MD.201514 | Other | LA | MD LICENSE |
| 418846 | Other | LA | MHN |
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