FRESH START COMMUNITY HEALTH CENTER LLC (NPI# 1689182792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689182792 |
| Entity Type | Organization |
| Organization Name | FRESH START COMMUNITY HEALTH CENTER LLC |
| Practice Address |
351 W 79th St Shreveport LA 71106 |
| Mailing Address |
351 W 79th St Shreveport LA 71106-4819 |
| Practice Telephone | 3186888190 |
| Mailing Telephone | 3187790873 |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2019-07-24 |
| Authorized Official Name | KEESHA S DINKINS (BUSINESS MANAGER) |
| Authorized Official Telephone | 3186888190 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities | ||
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities | ||
| Y | 261QR0800X |
Clinic/Center Specialization: Recovery Care |
Ambulatory Health Care Facilities |
| Street Address |
351 W 79TH ST |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891130084 | Positive Change Counseling Agency | Community/Behavioral Health | 351 W 79th St, Shreveport, LA 71106-4819 | 2013-05-01 |
| 1205340619 | Mahogany Murphy | Counselor | 351 W 79th St, Shreveport, LA 71106-4819 | 2017-11-21 |
| 1144734708 | Casey Thomas | Counselor | 351 W 79th St, Shreveport, LA 71106-4819 | 2017-11-18 |
| 1245742923 | Kathy Murphy | Counselor | 351 W 79th St, Shreveport, LA 71106-4819 | 2017-11-02 |
| 1861904609 | Yul Taylor | Counselor | 351 W 79th St, Shreveport, LA 71106-4819 | 2017-11-02 |
| 1720590938 | Teylor Washington | Counselor | 351 W 79th St, Shreveport, LA 71106-4819 | 2017-10-27 |
| 1164934535 | Tracy Richardson | Counselor | 351 W 79th St, Shreveport, LA 71106-4819 | 2017-10-25 |
| 1477064160 | Sherice Vivians | Counselor | 351 W 79th St, Shreveport, LA 71106-4819 | 2017-10-20 |
| 1275043259 | Janice Reed | Counselor | 351 W 79th St, Shreveport, LA 71106-4819 | 2017-10-04 |
| 1023528296 | Shammia Williams | Counselor | 351 W 79th St, Shreveport, LA 71106-4819 | 2017-10-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972008332 | Andrew Joseph Brouillette | Dentist | 385 Bert Kouns Industrial Loop Ste 700, Shreveport, LA 71106 | 2018-03-28 |
| 1548775885 | David Wayne Spears | Pharmacist | 10460 Norris Ferry Road, Shreveport, LA 71106 | 2017-12-08 |
| 1225559263 | Susan Anderson Roblow | Physical Therapist | 921 Unadilla Street, Shreveport, LA 71106 | 2017-06-29 |
| 1134656382 | James Lowder | Dentist | 8691 Line Ave Ste 300, Shreveport, LA 71106 | 2017-05-18 |
| 1144753708 | Laverne Brantley | Counselor | 328 E 69th St, Shreveport, LA 71106 | 2017-04-10 |
| 1437690849 | Biostat Laboratories, LLC | Clinical Medical Laboratory | 9742 Saint Vincent Ave Ste 200, Shreveport, LA 71106 | 2017-03-17 |
| 1841730728 | Cedric Thomas | Case Manager/Care Coordinator | 6811 Fairfield Avenue, Shreveport, LA 71106 | 2017-02-27 |
| 1225576192 | Nick Vergis | Pharmacist | 5828 Line Avenue, Shreveport, LA 71106 | 2017-02-10 |
| 1184162554 | Marilyn Johnson | Case Manager/Care Coordinator | 9245 Wallace Lake Rd Ste A, Shreveport, LA 71106 | 2017-02-06 |
| 1417499740 | Pamela Lee | Counselor | 8802 Coyth Ln, Shreveport, LA 71106 | 2016-11-17 |
| Find all providers in zip 71106 | ||||
| Taxonomy Code | 261QR0800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Recovery Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497208193 | Priority Care | Clinic/Center | 530 Lakeland Dr Ste 2b, Baton Rouge, LA 70802-4441 | 2016-07-28 |
| 1588930333 | Capital Area Human Services District | Clinic/Center | 5154 Burnett Road, St. Francisville, LA 70705 | 2012-03-27 |
| 1043585920 | Capital Area Human Services District | Clinic/Center | 12080 Marston Street, Clinton, LA 70720 | 2012-03-12 |
| 1508144502 | Capital Area Human Services District | Clinic/Center | 2751 Wooddale Blvd Ste A, Baton Rouge, LA 70805-7567 | 2011-07-26 |
| City | SHREVEPORT |
| Zip Code | 71106 |
Please comment or provide details below to improve the information on FRESH START COMMUNITY HEALTH CENTER LLC.
| 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.