=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609745439
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FRESH START BEHAVIORAL HEALTH SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/31/2025
-----------------------------------------------------
Last Update Date | 01/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 53 FRONTAGE RD BLDG 1
-----------------------------------------------------
City | HAMPTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08827-4031
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-386-2572
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 53 FRONTAGE RD FL 1
-----------------------------------------------------
City | HAMPTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08827-4031
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-386-2572
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | NP
-----------------------------------------------------
Name | JANE E EWUZIE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 908-386-2572
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------