Provider Demographics
NPI:1518406818
Name:NEW START RECOVERY, INC
Entity Type:Organization
Organization Name:NEW START RECOVERY, INC
Other - Org Name:FRESH START
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:L
Authorized Official - Last Name:MATHERNE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:985-223-4009
Mailing Address - Street 1:PO BOX 1812
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70361-1812
Mailing Address - Country:US
Mailing Address - Phone:985-223-4009
Mailing Address - Fax:985-223-7002
Practice Address - Street 1:214 HIGH ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4538
Practice Address - Country:US
Practice Address - Phone:985-223-4009
Practice Address - Fax:985-223-7002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2203782532276400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit