NPIMap

Organization Active NPI

Fresh Start Residential Services Inc

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Raleigh, NC
National Provider Identifier
1760547590
Registry record updated Feb 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
FRESH START RESIDENTIAL SERVICES INC
Practice address
2411 E Millbrook Rd
Suite 114
Raleigh, NC 27604-2800
Phone
(919) 790-7869
Fax
(919) 790-7864
NPI assigned
Dec 22, 2006
Last updated
Feb 10, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2009

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

Authorized official

Name
Mr. Michael E Parks
Title
President Ceo
Phone
(919) 790-7869

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X NC Primary

Addresses

Primary practice location

2411 E Millbrook Rd
Suite 114
Raleigh, NC 27604-2800

Mailing address

2411 E Millbrook Rd
Suite 114
Raleigh, NC 27604-2800
Phone (919) 790-7869

National Provider Directory

National Provider Directory
Tax ID family
Fresh Start Residential Services Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234224000000",
    "number": "1760547590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 E MILLBROOK RD",
            "address_2": "SUITE 114",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276042800",
            "telephone_number": "919-790-7869",
            "fax_number": "919-790-7864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 E MILLBROOK RD",
            "address_2": "SUITE 114",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276042800",
            "telephone_number": "919-790-7869",
            "fax_number": "919-790-7864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESH START RESIDENTIAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2009-02-10",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "919-790-7869",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2009; 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.