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COSTA MESA, CA
NPI1376326967
Entity TypeOrganization
Authorized ContactDAVID WAYNE PARKER
CEO
949-734-9254
Organization Subpart ?No
Primary Taxonomy261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder
Additional Taxonomies261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Enumeration Date2023-08-16
Last Update Date2024-07-22
Business Address
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204 E 17TH ST STE 203
COSTA MESA, CA 92627-7300
Phone number: 949-734-9254
Mailing Address
FRESH START RECOVERY SVCS
204 E 17TH ST STE 203
COSTA MESA, CA 92627-7300
Phone number: 949-734-9254