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General NPI Number Information
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NPI Number | 1407231699
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Entity Type | Organization
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Legal Business Name | A ROYAL FRESH START & ASSOCIATES INC.
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Dates
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Enumeration Date | 07/29/2015
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Last Update Date | 07/29/2015
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Provider Practice Location Address
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Address Line | 5420 NEW JESUP HWY # 187
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City | BRUNSWICK
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State | GA
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Zip | 31523-1137
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Country | US
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Telephone | 912-506-3011
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Fax |
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Provider Business Mailing Address
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Address Line | 3441 CYPRESS MILL RD SUITE 202-4
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City | BRUNSWICK
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State | GA
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Zip | 31520-2878
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Country | US
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Telephone | 912-342-8417
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KEANDRA J HILL
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Credential |
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Telephone | 912-506-3011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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