Provider Demographics
NPI:1407231699
Name:A ROYAL FRESH START & ASSOCIATES INC.
Entity Type:Organization
Organization Name:A ROYAL FRESH START & ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEANDRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-506-3011
Mailing Address - Street 1:3441 CYPRESS MILL RD
Mailing Address - Street 2:SUITE 202-4
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-2878
Mailing Address - Country:US
Mailing Address - Phone:912-342-8417
Mailing Address - Fax:
Practice Address - Street 1:5420 NEW JESUP HWY # 187
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31523-1137
Practice Address - Country:US
Practice Address - Phone:912-506-3011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty