Fresh Start Psychiatric Clinic
LBN: Fresh Start Psychiatric Clinic
Fresh Start Psychiatric Clinic is an health care organization with primary practice located at 11455 Fallbrook Dr Ste 201 , Houston TX 77065-4267. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Psychiatry, Ambulatory Health Care Facilities / Adult Mental Health, Ambulatory Health Care Facilities / Multi-Specialty. Ambulatory Health Care Facilities / Multi-Specialty is the primary health care specialty.
Fresh Start Psychiatric Clinic can be contacted via phone (337) 223-9487, or through Suire, Matthiaus via phone (512) 952-0295.
Contact Information
Primary practice address
11455 Fallbrook Dr Ste 201
Houston TX 77065-4267
Phone: (337) 223-9487
Fax: (888) 511-5650
Website:
Authorized official contact:
Name: Suire, Matthiaus Clinical Nurse Specialist (CNS)
Phone: (512) 952-0295
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Addiction Psychiatry | 2084P0802X | ||
| Ambulatory Health Care Facilities / Adult Mental Health | 261QM0850X | ||
| Ambulatory Health Care Facilities / Multi-Specialty | 261QM1300X |
Profile Details
| NPI number | 1427666353 |
|---|---|
| LBN Legal business name | Fresh Start Psychiatric Clinic |
| DBA Doing business as | |
| Authorized official | Suire, Matthiaus Clinical Nurse Specialist (CNS) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 16th, 2020 |
| Last updated | Jul 16th, 2021 - about 5 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427666353 | NPPES |
| Other | 11813129 | CAQH | |
| MEDICAID | 1029807 | CAQH | |
| Other | 600712760 | CAQH | |
| Other | NJ2611 | CAQH | |
| Other | MD.201514 | CAQH | |
| Other | 418846 | CAQH |
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