Fresh Start Family Services, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

FRESH START FAMILY SERVICES, LLC

Doing business as

Fresh Start Family Services, LLC

Practice address

2432 W Peoria Ave
Phoenix, AZ 85029-4726

Phone

(602) 825-1225

NPI assigned

Mar 15, 2022

Last updated

Apr 5, 2022By 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

John BlaylockNPI 1467129478

Title

Owner/Admin

Phone

(480) 431-5075

Specialties & licenses 1

Addresses

Other names 1

• Fresh Start Family Services, LLC Doing business as

Electronic endpoints 1

Tax ID family

A New Hope Behavioral Health Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• A New Hope Behavioral Health Home

  • Substance Abuse Rehabilitation Facility
  • Phoenix, AZ
  • NPI 1174108476
  NPD tax ID

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.

• John Luther Blaylock

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
  • NPI 1467129478
  Authorized official Same address or phone

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649116800000",
    "number": "1407504749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2432 W PEORIA AVE BLDG 16",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850294726",
            "telephone_number": "602-825-1225",
            "fax_number": "602-314-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2432 W PEORIA AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850294726",
            "telephone_number": "602-825-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESH START FAMILY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A",
        "authorized_official_last_name": "BLAYLOCK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER/ADMIN",
        "authorized_official_telephone_number": "480-431-5075"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "email",
            "affiliation": "N",
            "endpointDescription": "laptops",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2432 W Peoria Ave Bldg 16",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850294726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Fresh Start Family Services, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fresh Start Family Services, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Denis Sebastian Frent, PHARMD
• Lindsay Michele Frerichs, MD
• Fresenius Medical Care Biltmore, LLC (Fresenius Kidney Care Biltmore)
• Fresenius Medical Care Desert, LLC (Fresenius Medical Care Paradise Valley)
• Fresh Start Behavioral Services LLC
• Fresh Start Ic, PLLC
• Freshstart Recovery LLC
• Freshstart Recovery LLC
• Christopher Frett, PHARMD
• Kassie Shaw Fretto, DO

• Mental Health Clinic/Center (Including Community Mental Health Center) in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.