Start Fresh Alcohol Recovery Clinic

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

START FRESH ALCOHOL RECOVERY CLINIC

Practice address

720 North Tustin Ave , Suit #206
Santa Ana, CA 92705-3606

Phone

(714) 541-6100

Fax

(714) 541-9002

NPI assigned

Sep 8, 2010

Organization subpart

No

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

Authorized official

Name

Dr. George Nicholas Fallieras, M.D.

Title

Medical Director

Phone

(714) 541-6100

Specialties & licenses 1

Addresses

Other names 1

• Fresh Start Private Former legal business name

Tax ID family

Fresh Start Private2 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.

• Start Fresh Alcohol Recovery Clinic, Inc

  • Addiction Medicine (Internal Medicine) Physician
  • Las Vegas, NV
  • NPI 1497150007
  NPD tax ID

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384473600000",
    "number": "1902113244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 NORTH TUSTIN AVE , SUIT #206",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053606",
            "telephone_number": "714-541-6100",
            "fax_number": "714-541-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 NORTH TUSTIN AVE , SUIT #206",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053606",
            "telephone_number": "714-541-6100",
            "fax_number": "714-541-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "START FRESH ALCOHOL RECOVERY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-08",
        "last_updated": "2013-11-15",
        "status": "A",
        "authorized_official_last_name": "FALLIERAS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "NICHOLAS",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "714-541-6100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fresh Start Private",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Timothy Andrew Stanovich, SUD COUNSELOR
• Donna Stapp, MFT
• Starcare Medical Group, Inc.
• Amy Louise Stark, PHD
• Danae Marie Starkey
• Carol Anne Stashik, LCSW
• Dominic Anthony Stashik
• Statnie Physiotherapy PC
• Jasmine Staub, ABAT
• Selina Staub, ABAT

• Ambulatory Surgical Clinic/Center in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; 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.