NPIMap

Organization Active NPI

Fresh Start Residential Services, Inc.

  • Community/Behavioral Health Agency
  • Raleigh, NC
National Provider Identifier
1255519963
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FRESH START RESIDENTIAL SERVICES, INC.
Practice address
2411 E Millbrook Rd Ste 114
Raleigh, NC 27604-2800
Phone
(919) 790-7869
Fax
(919) 790-7864
NPI assigned
Feb 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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

Authorized official

Name
Mr. Michael Parks
Title
President/Ceo
Phone
(919) 790-7869

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NC Primary

Addresses

Primary practice location

2411 E Millbrook Rd Ste 114
Raleigh, NC 27604-2800

Mailing address

2411 E Millbrook Rd Ste 114
Raleigh, NC 27604-2800
Phone (919) 790-7869

National Provider Directory

National Provider Directory
Tax ID family
Fresh Start Residential Services Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

2411 E Millbrook Rd
Ste 114
Raleigh, NC 27604
Phone (919) 790-7869

NPI Registry JSON

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202169600000",
    "number": "1255519963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 E MILLBROOK RD STE 114",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276042800",
            "telephone_number": "919-790-7869",
            "fax_number": "919-790-7864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 E MILLBROOK RD STE 114",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276042800",
            "telephone_number": "919-790-7869",
            "fax_number": "919-790-7864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESH START RESIDENTIAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2008-02-05",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "919-790-7869",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.