FRESH START RESIDENTIAL SERVICES INC (NPI# 1336274083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336274083 |
| Entity Type | Organization |
| Organization Name | FRESH START RESIDENTIAL SERVICES INC |
| Practice Address |
3833 Buffaloe Rd Raleigh NC 27604-4210 |
| Mailing Address |
2411 E Millbrook Rd Ste 114 Raleigh NC 27604-2800 |
| Practice Telephone | 9197907869 |
| Practice Fax Number | 9197907864 |
| Mailing Telephone | 9197907869 |
| Mailing Fax Number | 9197907864 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. MICHAEL PARKS (PRESIDENT) |
| Authorized Official Telephone | 9197907869 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | MHL 092-621 | NC | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669507315 | Fresh Start Residential Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 5817 Old Forge Cir, Raleigh, NC 27609-4035 | 2007-02-22 |
| 1851426431 | Fresh Start Residential Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 4928 Coolridge Ct Apt A, Raleigh, NC 27616-5294 | 2007-02-22 |
| 1255466827 | Fresh Start Residential Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 5039 Sedgewick Dr Apt D, Raleigh, NC 27616-4576 | 2007-02-22 |
| 1760547590 | Fresh Start Residential Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2411 E Millbrook Rd, Suite 114, Raleigh, NC 27604-2800 | 2006-12-22 |
| Street Address |
3833 BUFFALOE RD |
| City | RALEIGH |
| State | NC |
| Zip Code | 27604-4210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689829293 | Life Changez Inc | Community/Behavioral Health | 3833 Buffaloe Rd, Raleigh, NC 27604-4210 | 2008-11-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326669748 | Monet Josey | Counselor | 3020 Highwood Blvd, Raleigh, NC 27604 | 2020-04-27 |
| 1154979094 | Ride4health Transportation Inc | Non-emergency Medical Transport (VAN) | 3200 Capital Blvd, Raleigh, NC 27604 | 2019-09-03 |
| 1851890750 | Sasilana Letreva Burden | In Home Supportive Care | 4000 Northstone Drive Apt 307, Raleigh, NC 27604 | 2018-02-06 |
| 1093226383 | The Eye Institute Od, Pa | Optometrist | 111 Seaboard Ave Ste 110, Raleigh, NC 27604 | 2017-10-13 |
| 1902326044 | Ngozi Ifeoma Osiebo | Nurse Practitioner | 4608 Wedgewood Drive, Raleigh, NC 27604 | 2017-06-20 |
| 1144765520 | Rose Hill Family Care Home | Custodial Care Facility | 1705 Beacon Bluff Street, Raleigh, NC 27604 | 2016-12-21 |
| 1437609948 | Mercy Manor At Saybrooke, Inc | Custodial Care Facility | 6320 Saybrooke Drive, Raleigh, NC 27604 | 2016-10-07 |
| 1972969913 | Shivas Gilotra | Nurse Practitioner | 805 Oberlin Road, Ste 200, Raleigh, NC 27604 | 2016-01-06 |
| 1609247915 | Charisse Justine Young | Social Worker | 2609 Atlantic Avenue, Suite 111c, Raleigh, NC 27604 | 2015-10-13 |
| 1356748933 | John T Hart | Counselor | 1115-113 Cove Bridge Road, Raleigh, NC 27604 | 2014-11-26 |
| Find all providers in zip 27604 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598133209 | S.t.e.p. Up Behavioral Services, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 5809 N Beaver Ln, Raleigh, NC 27604-6057 | 2015-09-11 |
| 1033358825 | Chance Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1305 Hendren Cir, Raleigh, NC 27610-4937 | 2009-02-18 |
| 1386805984 | Carrington Children Family Services, L.l.c | Residential Treatment Facility, Emotionally Disturbed Children | 4401 Goldcrest Ln, Raleigh, NC 27616-8816 | 2008-06-17 |
| 1003005240 | Phyd, Inc. (pretty Homes Youth Development) | Residential Treatment Facility, Emotionally Disturbed Children | 1611 Poole Rd, Raleigh, NC 27610-2658 | 2007-10-23 |
| 1043409113 | Hope Services, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 8909 Sauls Rd, Raleigh, NC 27603-8726 | 2007-10-15 |
| 1992918627 | 2nd Chance Home for Children | Residential Treatment Facility, Emotionally Disturbed Children | 729 Kavkaz St, Raleigh, NC 27610-3174 | 2007-05-08 |
| 1639205701 | Gill House | Residential Treatment Facility, Emotionally Disturbed Children | 845 Cross Link Rd, Raleigh, NC 27610-4730 | 2007-02-26 |
| 1669507315 | Fresh Start Residential Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 5817 Old Forge Cir, Raleigh, NC 27609-4035 | 2007-02-22 |
| 1851426431 | Fresh Start Residential Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 4928 Coolridge Ct Apt A, Raleigh, NC 27616-5294 | 2007-02-22 |
| 1255466827 | Fresh Start Residential Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 5039 Sedgewick Dr Apt D, Raleigh, NC 27616-4576 | 2007-02-22 |
| Find all providers in RALEIGH | ||||
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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.