FRESH START COMMUNITY DEVELOPERS, LLC (NPI# 1114273315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114273315 |
| Entity Type | Organization |
| Organization Name | FRESH START COMMUNITY DEVELOPERS, LLC |
| Practice Address |
46 Sycamore Sta Decatur GA 30030-2757 |
| Practice Telephone | 4042459265 |
| Practice Fax Number | 4043701202 |
| Mailing Telephone | 4042459265 |
| Mailing Fax Number | 4043701202 |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2012-07-25 |
| Authorized Official Name | MR. KIRK MICHAEL WILLIAMS (CERTIFIED ADDICTION COUNSELOR) |
| Authorized Official Telephone | 4042459265 |
| Authorized Official Credential | MS, CADC, ICRC, |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
236 | GA | Behavioral Health & Social Service Providers |
| Street Address |
46 SYCAMORE STA |
| City | DECATUR |
| State | GA |
| Zip Code | 30030-2757 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801413174 | Pa-c Surgical Assist, LLC | Clinic/Center | 520 W Ponce Leon Ave #1706, Decatur, GA 30030 | 2020-07-02 |
| 1417587478 | Elizabeth Heffron | Acupuncturist | 619b East College Avenue, Decatur, GA 30030 | 2020-01-17 |
| 1669016143 | Atlanta Upper Cervical Chiropractic LLC | Chiropractor | 125 E Trinity Place, Suite #247, Decatur, GA 30030 | 2019-10-29 |
| 1831757418 | Jessica Stewart | Counselor | 755 Commerce Dr Ste 903, Decatur, GA 30030 | 2019-05-30 |
| 1699238733 | Dinah Augustin | Registered Nurse | 1458 Church St., Unit B, Decatur, GA 30030 | 2019-04-06 |
| 1093284291 | Eliza Segell | Social Worker | 165 Dekalb Industrial Way Ste D-1, Decatur, GA 30030 | 2018-11-16 |
| 1912476466 | Positive Impact Health Centers, Inc. | Pharmacy | 523 Church Street, Suite B, Decatur, GA 30030 | 2018-11-14 |
| 1932685096 | T2 Imaging | Radiology | 1376 Church Street, Suite 100, Decatur, GA 30030 | 2018-07-12 |
| 1992292858 | Keeanna M Powell | Counselor | Agape Transformation Practice, 235 E. Ponce De Leon Ave Suite 103, Decatur, GA 30030 | 2018-04-17 |
| 1780185488 | Solutions Ae Inc | Counselor | One West Square Court, Suite 710, Decatur, GA 30030 | 2018-02-27 |
| Find all providers in zip 30030 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578115564 | Averette Consultation & Therapy, LLC | Counselor | 2789 Lakeview Walk, Decatur, GA 30035-4061 | 2019-07-10 |
| 1972070274 | Lelah Ray | Counselor | 235 N Mill St Ste 800, Decatur, IL 62523-1381 | 2018-10-25 |
| 1821540865 | Heritage Behavioral Health Center | Counselor | 1029 N Water St, Decatur, IL 62523-1022 | 2016-10-25 |
| 1700246709 | Kimberly Moss Wilson | Counselor | 1116 E Ponce De Leon Ave, Decatur, GA 30030-2711 | 2016-03-03 |
| 1053749168 | Matthew Wagner | Counselor | 545 N Mcdonough St Ste 212, Decatur, GA 30030-3310 | 2013-10-29 |
| 1699011155 | Whitney Terree Tyler | Counselor | 3630 Camp Cir Ste 102, Decatur, GA 30032-1304 | 2013-01-02 |
| 1518103662 | Lunye Geter | Counselor | 2799 Lawrenceville Highway, Ste 201, Decatur, GA 30033-2517 | 2008-12-19 |
| 1346416013 | Elaine Rowland Tophia | Counselor | 2283 Waters Run, Decatur, GA 30035-2528 | 2008-05-02 |
| 1891964995 | Sheryl A White | Counselor | 1106 E Business Hwy 380, Decatur, TX 76234 | 2008-02-22 |
| 1851438998 | Martha Kay Birch | Counselor | 247 W Prairie Ave, Decatur, IL 62523-1220 | 2007-01-30 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.