| NPI | 1578808663 |
|---|---|
| Doing Business As | FRESH START PCS |
| Entity Type | Organization |
| Authorized Contact | SHERRY L WAGNER CFO 320-589-4919 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MN FBL-21674-37286) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MN 1060122-1-RMI) |
| Enumeration Date | 2012-11-30 |
| Last Update Date | 2013-07-24 |