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NPI Code Detail

MEDICARE: A FRESH BEGINNING LLC

MEDICARE: A FRESH BEGINNING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251C00000XDevelopmentally Disabled Services Day Training Agency
2251S00000XCommunity/Behavioral Health Agency
3320600000XIntellectual and/or Developmental Disabilities Residential Treatment Facility
4385H00000XRespite Care

General Provider Information

NPI Number : 1306966429
Entity Type Code : Organization
Provider Name (Legal Business Name) : A FRESH BEGINNING LLC
Provider Business Mailing Address
First Line : 15280 TRANSIT RD
Second Line :
City : SAINT ROBERT
State : MO
Zip : 65584-3221
Country : US
Telephone Number : 573-426-2418
Fax Number : 573-426-2419
Provider Business Practice Location Address
First Line : 15280 TRANSIT RD
Second Line :
City : SAINT ROBERT
State : MO
Zip : 65584-3221
Country : US
Telephone Number : 573-426-2418
Fax Number : 573-426-2419
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. JAMES M DAVIS JR.
Credential :
Telephone Number : 573-426-2418
Provider Enumeration Date : 03/30/2007
Last Update Date : 09/11/2025

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Directions to “A FRESH BEGINNING LLC ” Practice Location

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