NPIMap

Organization Active NPI

Freshstart Recovery LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1104466697
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
FRESHSTART RECOVERY LLC
Practice address
2914 W Donner Dr
Phoenix, AZ 85041-6343
Phone
(480) 343-0086
NPI assigned
Jan 13, 2020
Organization subpart
Yes
Parent organization
FRESHSTART RECOVERY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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

Authorized official

Name
Sanova Dear
Title
Administrator
Phone
(480) 343-0086

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

2914 W Donner Dr
Phoenix, AZ 85041-6343

Mailing address

28518 N 26TH Dr
Phoenix, AZ 85085-3726

National Provider Directory

National Provider Directory
Tax ID family
Freshstart Recovery LLC2 organizations share this tax ID, including this one
Part of
Freshstart Recovery LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578873600000",
    "number": "1104466697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28518 N 26TH DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850853726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2914 W DONNER DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850416343",
            "telephone_number": "480-343-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESHSTART RECOVERY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESHSTART RECOVERY LLC",
        "enumeration_date": "2020-01-13",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A",
        "authorized_official_last_name": "DEAR",
        "authorized_official_first_name": "SANOVA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "480-343-0086"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2020; 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.