Provider Demographics
NPI:1760609929
Name:FRESH START SERVICES, LLC
Entity Type:Organization
Organization Name:FRESH START SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GIRMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAID
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:702-631-3319
Mailing Address - Street 1:PO BOX 570924
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89157-0924
Mailing Address - Country:US
Mailing Address - Phone:702-631-3319
Mailing Address - Fax:702-631-0051
Practice Address - Street 1:2521 APRICOT LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-3555
Practice Address - Country:US
Practice Address - Phone:702-631-3319
Practice Address - Fax:702-631-0051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health