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Organization
FRESH BEGINNINGS LIFE CHANGING ORGANIZATION
Active
Organization
FRESH BEGINNINGS LIFE CHANGING ORGANIZATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WYNNETTE WILLIAMS (CEO)
(713) 530-4192
Entity
Organization
Contact information
Practice address
7863 LUMBER JACK DR, HOUSTON, TX 77040-1740
(713) 530-4192
Mailing address
PO BOX 40292, HOUSTON, TX 77240-0292
(713) 530-4192
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000000
—
TX
Enumeration date
05/07/2020
Last updated
05/07/2020
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