Provider Demographics
NPI:1689920282
Name:FRESH BEGINNING, INC.
Entity Type:Organization
Organization Name:FRESH BEGINNING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-830-7400
Mailing Address - Street 1:72 W 11TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-3906
Mailing Address - Country:US
Mailing Address - Phone:209-830-7400
Mailing Address - Fax:209-833-8386
Practice Address - Street 1:1852 W. 11TH STREET
Practice Address - Street 2:#699
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376
Practice Address - Country:US
Practice Address - Phone:209-830-7400
Practice Address - Fax:209-833-8386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility