| NPI | 1376799585 |
|---|---|
| Other Name | FRESH START HOME FOR CHILDREN |
| Entity Type | Organization |
| Authorized Contact | TRACI JOHNSON MARTIN Owner 336-375-3901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC MHL-041-1095) |
| 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC MHL-041-1115) | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: NC MHL041857) | |
| 385H00000X Respite Care (Licence: NC MHL-041-1115) | |
| 251S00000X (Licence: NC MHL-041-1115) | |
| 251S00000X (Licence: NC MHL-041-1095) | |
| 253Z00000X In Home Supportive Care (Licence: NC MHL0411095) | |
| 253Z00000X In Home Supportive Care (Licence: NC MHL-041-1115) | |
| 253Z00000X In Home Supportive Care | |
| 311Z00000X Custodial Care Facility | |
| 385H00000X Respite Care (Licence: NC MHL-041-1095) | |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2022-05-03 |