| Fresh Start Therapeutic Services, Llc | |
|
626 Towne Center Dr Ste 204 Joppa MD 21085-4451 | |
| (443) 313-3240 | |
| (443) 313-3234 |
| Full Name | Fresh Start Therapeutic Services, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 626 Towne Center Dr Ste 204, Joppa, Maryland |
| Authorized Official Name and Position | Tekora Nichols (REHABILITATION SPECIALIST) |
| Authorized Official Contact | 2403709479 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fresh Start Therapeutic Services, Llc 1307 Liatris Ln Belcamp MD 21017-1660 Ph: () - | Fresh Start Therapeutic Services, Llc 626 Towne Center Dr Ste 204 Joppa MD 21085-4451 Ph: (443) 313-3240 |
| NPI Number | 1437767852 |
|---|---|
| Provider Enumeration Date | 07/22/2020 |
| Last Update Date | 07/22/2020 |
| Certification Date | 07/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437767852 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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