Provider Demographics
NPI:1558927111
Name:A FRESH START TO A NEW BEGINNING
Entity Type:Organization
Organization Name:A FRESH START TO A NEW BEGINNING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NADJA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:MARION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-690-0327
Mailing Address - Street 1:213 RHONDA CIR E
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-4325
Mailing Address - Country:US
Mailing Address - Phone:901-690-0327
Mailing Address - Fax:
Practice Address - Street 1:213 RHONDA CIR E
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-4325
Practice Address - Country:US
Practice Address - Phone:901-690-0327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-18
Last Update Date:2019-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251300000XAgenciesLocal Education Agency (LEA)
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No251V00000XAgenciesVoluntary or Charitable
No252Y00000XAgenciesEarly Intervention Provider Agency
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No333300000XSuppliersEmergency Response System Companies
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)