| Fresh Start, Inc. | |
|
100 Beauvais Ave Suite A-1 Lafayette LA 70507-2468 | |
| (337) 886-1617 | |
| (337) 886-1588 |
| Full Name | Fresh Start, Inc. |
|---|---|
| Speciality | Clinic/center |
| Location | 100 Beauvais Ave, Lafayette, Louisiana |
| Authorized Official Name and Position | Kendall Errond Williams (PRESIDENT/PROGRAM DIRECTOR) |
| Authorized Official Contact | 3378861617 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fresh Start, Inc. 100 Beauvais Ave Suite A-1 Lafayette LA 70507-2468 Ph: (337) 886-1617 | Fresh Start, Inc. 100 Beauvais Ave Suite A-1 Lafayette LA 70507-2468 Ph: (337) 886-1617 |
| NPI Number | 1588610554 |
|---|---|
| Provider Enumeration Date | 05/25/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588610554 | NPI | - | NPPES |
| 1428396 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | AD601 (Louisiana) | Primary |
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