# FRESH START RECOVERY SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396161337
- **Authorized official:** MR. DAVID WAYNE PARKER LAADC, ICADC (PRESIDENT)
- **Authorized official phone:** (949) 200-2341

## Contact information

- **Practice address:** 2790 HARBOR BLVD, SUITE \#307, COSTA MESA, CA 92626-5154
- **Practice address phone:** (949) 200-2341
- **Mailing address:** 2790 HARBOR BLVD, SUITE \#307, COSTA MESA, CA 92626-5154
- **Mailing address phone:** (949) 200-2341

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0401X | Comprehensive Outpatient Rehabilitation Facility (CORF) | — | CA | Yes |

## Other

- **Enumeration date:** 03/14/2014
- **Last updated:** 03/14/2014