National Provider Identifier Database

FRESH START COMMUNITY HEALTH CENTER LLC
Recovery Care


Contact Information

FRESH START COMMUNITY HEALTH CENTER LLC
351 W 79TH ST
SHREVEPORT, LA71106
Phone: 318-688-8190
Fax:
Website:
Specialty Taxonomy Code
* Recovery Care 261QR0800X
Community Health 261QC1500X
Primary Care 261QP2300X

* Indicates primary specialty

NPI Profile & details for FRESH START COMMUNITY HEALTH CENTER LLC

NPI Number 1689182792
Legal business name
LBN
FRESH START COMMUNITY HEALTH CENTER LLC
Authorized official KEESHA DINKINS - (BUSINESS MANAGER)
Entity Organization
Organization subpart No
Enumeration date 01/11/2018
Last updated 07/24/2019 - About 7 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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