# FRESH BEGINNINGS LIFE CHANGING ORGANIZATION

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

## Provider details

- **NPI number:** 1710509252
- **Authorized official:** WYNNETTE WILLIAMS (CEO)
- **Authorized official phone:** (713) 530-4192

## Contact information

- **Practice address:** 7863 LUMBER JACK DR, HOUSTON, TX 77040-1740
- **Practice address phone:** (713) 530-4192
- **Mailing address:** PO BOX 40292, HOUSTON, TX 77240-0292
- **Mailing address phone:** (713) 530-4192

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080P0006X | Developmental - Behavioral Pediatrics Physician | — | — | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |
| 3245S0500X | Children's Substance Abuse Rehabilitation Facility | — | — | — |

## Other

- **Enumeration date:** 05/07/2020
- **Last updated:** 05/07/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0000000 | — | TX |