Fresh Start Recovery Services

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

FRESH START RECOVERY SERVICES

Practice address

2790 Harbor Blvd
Suite #307
Costa Mesa, CA 92626-5154

Phone

(949) 200-2341

NPI assigned

Mar 14, 2014

Last updated

Mar 14, 2014By 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, LAADC, ICADC

Title

President

Phone

(949) 200-2341

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1394755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394755200000",
    "number": "1396161337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 HARBOR BLVD",
            "address_2": "SUITE #307",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265154",
            "telephone_number": "949-200-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 HARBOR BLVD",
            "address_2": "SUITE #307",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265154",
            "telephone_number": "949-200-2341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESH START RECOVERY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-14",
        "last_updated": "2014-03-14",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-200-2341",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LAADC, ICADC"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• Comprehensive Outpatient Rehabilitation Facility (CORF) in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2014; 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.