Fresh Start Private Florida

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

FRESH START PRIVATE FLORIDA

Practice address

1415 Panther LN
Naples, FL 34109-7874

Phone

(239) 591-6240

NPI assigned

Sep 13, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Timothy Jon Jackoboice

Title

Ceo

Phone

(239) 591-6240

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347494400000",
    "number": "1003166307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 PANTHER LN",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341097874",
            "telephone_number": "239-591-6240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 PANTHER LN",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341097874",
            "telephone_number": "239-591-6240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESH START PRIVATE FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-13",
        "last_updated": "2012-09-13",
        "status": "A",
        "authorized_official_last_name": "JACKOBOICE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "239-591-6240"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ari Frenkel
• Lindsay Gail Frenkel, M.D.
• Mark Benjamin Frenkel, M.D.
• Jacquelyn Delores Fresenius, LMHC
• Fresh Oasis Inc.
• Edilka Mariela Frias de Gracia de Fe, RBT
• Dasha Frias Landa, D.M.D.
• Bradley Frick, DC
• Friedman Pain Management
• Stephen L Friedman, MD

• Substance Use Disorder Rehabilitation Clinic/Center in Naples, FL
• Providers in Naples, FL by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.