Fresh Start Youth Services, Inc.

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

081067 Issued in NC

Legal business name

FRESH START YOUTH SERVICES, INC.

Practice address

429 Bostic Sunshine Hwy
Bostic, NC 28018-9775

Phone

(704) 226-2469

Fax

(704) 290-2399

NPI assigned

Nov 30, 2006

Last updated

Aug 22, 2020By 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. William E. Lheureux, MA, MPA

Title

Ceoexecutive Director

Phone

(704) 226-2469

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Fresh Start Youth Services Inc2 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.

• Fresh Start Youth Services, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Monroe, NC
  • NPI 1811022718
  NPD tax ID

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790853646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 BOSTIC SUNSHINE HWY",
            "city": "BOSTIC",
            "state": "NC",
            "postal_code": "280189775",
            "telephone_number": "704-226-2469",
            "fax_number": "704-290-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 BOSTIC SUNSHINE HWY",
            "city": "BOSTIC",
            "state": "NC",
            "postal_code": "280189775",
            "telephone_number": "704-226-2469",
            "fax_number": "704-290-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESH START YOUTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LHEUREUX",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CEOEXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "704-226-2469",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA, MPA"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "081067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6604020",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Emotionally Disturbed Childrens' Residential Treatment Facility in Bostic, NC
• Providers in Bostic, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.