A Fresh Start and New Beginnings

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

BH3871 Issued in AZ

Legal business name

A FRESH START AND NEW BEGINNINGS

Practice address

4105 W Villa Linda Dr
Glendale, AZ 85310-5157

Phone

(623) 434-2126

Fax

(623) 434-1494

NPI assigned

Apr 15, 2011

Last updated

Jul 1, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Beverly Bailey

Title

Ceo

Phone

(323) 379-6249

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1302825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309478400000",
    "number": "1316237076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 W VILLA LINDA DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853105157",
            "telephone_number": "623-434-2126",
            "fax_number": "623-434-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 W VILLA LINDA DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853105157",
            "telephone_number": "623-434-2126",
            "fax_number": "623-434-1494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A FRESH START AND NEW BEGINNINGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-15",
        "last_updated": "2011-07-01",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-379-6249"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "AZ",
            "license": "BH3871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; 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.