Fresh Start Recovery SVCS

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

FRESH START RECOVERY SVCS

Practice address

204 E 17TH St Ste 203
Costa Mesa, CA 92627-7300

Phone

(949) 734-9254

NPI assigned

Aug 16, 2023

Last updated

Jul 22, 2024By 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

Mr. David Wayne Parker, LAADCNPI 1942041371

Title

Ceo

Phone

(949) 734-9254

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Wayne Parker, LAADC

  • Addiction (Substance Use Disorder) Counselor
  • Costa Mesa, CA
  • NPI 1942041371
  NPD Authorized official

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

{
    "created_epoch": "1692144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1376326967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 E 17TH ST STE 203",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926277300",
            "telephone_number": "949-734-9254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 E 17TH ST STE 203",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926277300",
            "telephone_number": "949-734-9254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESH START RECOVERY SVCS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-16",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-734-9254",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LAADC"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaneska Frederique
• Chelsea Freeman, B.A.
• Dakota Edward John Freeman
• Helen Yvonne French
• Fresh Start Recovery Services
• Josie Marla Frias
• Butch Lawrence Froberg, LCSW
• Lynda L Frye, M.D.
• Melissa Fryhling, PHARMD.
• Edward Fu

• Substance Use Disorder Rehabilitation Clinic/Center in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.