Fresh Start Rehab LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

FRESH START REHAB LLC

Practice address

624 S Fayetteville St Ste C
Asheboro, NC 27203-6582

Phone

(743) 224-7107

NPI assigned

Aug 1, 2025

Organization subpart

No

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

Authorized official

Name

Miss Jariksa Menjivar

Title

Owner

Phone

(743) 224-7107

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1754006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754006400000",
    "number": "1033093158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 S FAYETTEVILLE ST STE C",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272036582",
            "telephone_number": "743-224-7107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 S FAYETTEVILLE ST STE C",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272036582",
            "telephone_number": "743-224-7107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESH START REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-01",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A",
        "authorized_official_last_name": "MENJIVAR",
        "authorized_official_first_name": "JARIKSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "743-224-7107",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Marie Indelicato Fox, APRN
• Krista L Frazier, MPT
• Bryan Charles Freeman, DDS
• Cheryl Goble Freeman, DDS
• Wendy Freihart, HCP
• Susan A Fuller, DNP, NP
• Victoria G Fulton, DDS
• Craig Stephen Gaccione, M.D.
• Marion Louise Gaddy, PHLEBOTOMY
• Wanda McCain Gaines, LPC

• Substance Use Disorder Rehabilitation Clinic/Center in Asheboro, NC
• Providers in Asheboro, NC by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; 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.