Organization · NPI-2
A Fresh Start Org INC
Voluntary or Charitable · Rocky Mount, NC
NPI number1174270342
StatusActive
Last updated in NPPESMar 14, 2022
Details
- NPI
- 1174270342
- Entity type
- Organization (NPI-2)
- Legal business name
- A Fresh Start Org INC
- Organization subpart
- No
- Enumeration date
- Mar 7, 2022
- Certification date
- Mar 14, 2022
- Last updated
- Mar 14, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251V00000X | Voluntary or Charitable | – | – | Yes |
| 311ZA0620X | Custodial Care Facility, Adult Care Home | – | – |
Practice location
301 S Church St Ste 153Rocky Mount, NC 27804-5748
Phone 252-822-1790 · Fax 252-577-4677
Mailing address
301 S Church St Ste 153Rocky Mount, NC 27804-5748
Phone 252-822-1790 · Fax 252-577-4677
Authorized official
Adrianne C Hall
Admin
2528221790
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