| Fresh Start Comprehensive Center | |
|
8492 Baltimore National Pike Ellicott City MD 21043-3370 | |
| (443) 671-1414 | |
| (443) 671-1420 |
| Full Name | Fresh Start Comprehensive Center |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 8492 Baltimore National Pike, Ellicott City, Maryland |
| Authorized Official Name and Position | Terri Fields (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 4438847521 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fresh Start Comprehensive Center 11 E Mount Royal Ave Ste Ll Baltimore MD 21202-2714 | Fresh Start Comprehensive Center 8492 Baltimore National Pike Ellicott City MD 21043-3370 Ph: (443) 671-1414 |
| NPI Number | 1124557871 |
|---|---|
| Provider Enumeration Date | 06/07/2017 |
| Last Update Date | 03/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124557871 | NPI | - | NPPES |
| 424075801 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | () | Primary |
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