# FRESH START THERAPY

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

## Provider details

- **NPI number:** 1568883452
- **Authorized official:** LORENA AVILA (COTA /PRESIDENT)
- **Authorized official phone:** (954) 696-6515

## Contact information

- **Practice address:** 4317 SW 125TH LN, MIRAMAR, FL 33027-6015
- **Practice address phone:** (954) 696-6515
- **Mailing address:** 4317 SW 125TH LN, MIRAMAR, FL 33027-6015

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 11580 | FL | Yes |

## Other

- **Enumeration date:** 12/19/2013
- **Last updated:** 12/19/2013