Fresh Start Youth Services, Inc.

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

090143 Issued in NC

Legal business name

FRESH START YOUTH SERVICES, INC.

Practice address

2110 Griffith Rd
Monroe, NC 28112-8833

Phone

(704) 282-4243

Fax

(704) 218-6743

NPI assigned

Feb 22, 2007

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 Edmond Lheureux, MA, MPA

Title

Ceo Executive 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
  • Bostic, NC
  • NPI 1790853646
  NPD tax ID

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811022718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 GRIFFITH RD",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281128833",
            "telephone_number": "704-282-4243",
            "fax_number": "704-218-6743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 GRIFFITH RD",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281128833",
            "telephone_number": "704-282-4243",
            "fax_number": "704-218-6743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESH START YOUTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LHEUREUX",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "EDMOND",
        "authorized_official_title_or_position": "CEO EXECUTIVE 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": "090143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603451",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynn Little Frederick, RN
• Kaitlyn Free
• Madison Amanda Freeman, M.S., CCC-SLP
• Sarise B. Freiman, MD
• Abigail Rae Fremer, OTR/L
• Thomas C Friedrich, MD
• Friendship Home of Monroe, Inc. (Friendship Home, Inc.)
• Travis Michael Fry
• Full Circle Pediatric Therapy
• Marlon Monty Fuller, PHARMD

• Emotionally Disturbed Childrens' Residential Treatment Facility in Monroe, NC
• Providers in Monroe, 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.