Addis Consulting Inc.

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

ADDIS CONSULTING INC.

Doing business as

Fresh Start Comprehensive Center

Practice address

8492 Baltimore National Pike
Ellicott City, MD 21043-3370

Phone

(443) 671-1414

Fax

(443) 671-1420

NPI assigned

Jun 7, 2017

Organization subpart

Yes

Parent organization

ADDIS CONSULTING INCAs reported in NPPES

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

Authorized official

Name

Terri Fields

Title

Practice Administrator

Phone

(443) 884-7521

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Fresh Start Comprehensive Center Doing business as

Tax ID family

Addis Consulting Inc2 organizations share this tax ID, including this one

Part of

Addis Consulting Inc

Other organizations with this tax ID 1

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

• Addis Consulting Inc.

  dba Fresh Start Comprehensive Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Baltimore, MD
  • NPI 1427441880
  NPD tax ID

Locations

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1124557871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 E MOUNT ROYAL AVE STE LL",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8492 BALTIMORE NATIONAL PIKE",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433370",
            "telephone_number": "443-671-1414",
            "fax_number": "443-671-1420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 E Mount Royal Ave",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212022714",
            "country_code": "US",
            "telephone_number": "443-671-1414",
            "fax_number": "443-671-1420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADDIS CONSULTING INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADDIS CONSULTING INC",
        "enumeration_date": "2017-06-07",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "FIELDS",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "443-884-7521"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "424075801",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fresh Start Comprehensive Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.