Fresh Beginnings Life Changing Organization

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

FRESH BEGINNINGS LIFE CHANGING ORGANIZATION

Practice address

7863 Lumber Jack Dr
Houston, TX 77040-1740

Phone

(713) 530-4192

NPI assigned

May 7, 2020

Organization subpart

No

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

Authorized official

Name

Wynnette Williams

Title

Ceo

Phone

(713) 530-4192

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1588809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588809600000",
    "number": "1710509252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40292",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772400292",
            "telephone_number": "713-530-4192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7863 LUMBER JACK DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770401740",
            "telephone_number": "713-530-4192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESH BEGINNINGS LIFE CHANGING ORGANIZATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-07",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "WYNNETTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "713-530-4192"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000000",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Houston",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Houston",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Houston",
            "address_1": "7863 Lumber Jack Dr",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770401740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Emotionally Disturbed Childrens' Residential Treatment Facility in Houston, TX
• Providers in Houston, TX by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; 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.