Provider Demographics
NPI:1649973108
Name:F.R.E.S.H BEHAVIORAL SERVICES
Entity type:Organization
Organization Name:F.R.E.S.H BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:DHS
Authorized Official - Phone:772-323-1856
Mailing Address - Street 1:2020 W FAIRBANKS AVE STE 211A
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4547
Mailing Address - Country:US
Mailing Address - Phone:407-951-5022
Mailing Address - Fax:386-310-2482
Practice Address - Street 1:2020 W FAIRBANKS AVE STE 211A
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4547
Practice Address - Country:US
Practice Address - Phone:407-951-5022
Practice Address - Fax:386-310-2482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-23
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder