Fresh Start Clubhouse, Inc.

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

FRESH START CLUBHOUSE, INC.

Practice address

211 E Michigan Ave Uppr
Ypsilanti, MI 48198-5677

Phone

(734) 929-9992

NPI assigned

Dec 6, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Webb Lucas, COTA

Title

Executive Director

Phone

(734) 929-9992

Specialties & licenses 2

Addresses

Other names 1

• Fresh Start Other name

Locations

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727049600000",
    "number": "1780395277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E MICHIGAN AVE UPPR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481985677",
            "telephone_number": "734-929-9992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E MICHIGAN AVE UPPR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481985677",
            "telephone_number": "734-929-9992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESH START CLUBHOUSE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-06",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "WEBB",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "734-929-9992",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "COTA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fresh Start",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Fresh Start",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Cynthia Frederiksen, CNP
• Freedom Therapeutic Services
• Nicole Rene Frei, MD
• John E Freitas, M.D.
• Jejuan Quintel French
• Nathaniel Friedman
• Jennifer Fritz, LMSW
• Margaret Theresa Fry, LPN
• Theresa Fry, LPC
• Allison Frymier

• Adult Mental Health Clinic/Center in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Adult Mental Health Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.