Provider Demographics
NPI:1477172377
Name:NEW ROADS HEALTH, LLC
Entity Type:Organization
Organization Name:NEW ROADS HEALTH, LLC
Other - Org Name:FRESHSTART INNOVATION CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CNP
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PINLAC
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN
Authorized Official - Phone:602-699-4536
Mailing Address - Street 1:2906 E UNION HILLS DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-3430
Mailing Address - Country:US
Mailing Address - Phone:602-699-4536
Mailing Address - Fax:803-265-0563
Practice Address - Street 1:2906 E UNION HILLS DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-3430
Practice Address - Country:US
Practice Address - Phone:602-699-4536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-10
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty