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NPI Code Detail

MEDICARE: FRESH START RECOVERY. LLC

MEDICARE: FRESH START RECOVERY. 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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1952949844
Entity Type Code : Organization
Provider Name (Legal Business Name) : FRESH START RECOVERY. LLC
Provider Business Mailing Address
First Line : 8918 READING RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45215-3228
Country : US
Telephone Number : 513-377-9374
Fax Number :
Provider Business Practice Location Address
First Line : 8918 READING RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45215-3228
Country : US
Telephone Number : 513-377-9374
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : RACHELE SMITH
Credential :
Telephone Number : 513-377-9374
Provider Enumeration Date : 12/11/2019
Last Update Date : 12/11/2019

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