# FRESH START PRIVATE MIDWEST LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Start Fresh Alcohol Recovery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598147266
- **Authorized official:** GRIFFITH F EVANS M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (402) 884-1221

## Contact information

- **Practice address:** 2827 S 88TH ST, OMAHA, NE 68124-3056
- **Practice address phone:** (402) 884-1221
- **Practice address fax:** (402) 884-1335
- **Mailing address:** 2827 S 88TH ST, OMAHA, NE 68124-3056
- **Mailing address phone:** (402) 884-1221
- **Mailing address fax:** (402) 884-1335

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 207LPZ900X | NE | Yes |

## Other

- **Enumeration date:** 06/18/2015
- **Last updated:** 06/18/2015