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General NPI Number Information
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NPI Number | 1639045909
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Entity Type | Organization
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Legal Business Name | FRESH START ADDICTION TREATMENT
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Dates
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Enumeration Date | 10/14/2025
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 1307 WHITE HORSE RD STE A103
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City | VOORHEES
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State | NJ
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Zip | 08043-2176
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Country | US
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Telephone | 609-864-5819
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Fax | 609-864-5819
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Provider Business Mailing Address
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Address Line | 1307 WHITE HORSE RD STE A103
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City | VOORHEES
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State | NJ
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Zip | 08043-2176
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Country | US
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Telephone | 609-864-5819
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Fax | 609-864-5819
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CAITLIN MACALLISTER
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Credential |
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Telephone | 609-864-5819
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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