Organization
FRESH NEW START
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHARLENE K WETENDORF (OWNER)
(260) 701-1934
Entity
Organization
Contact information
Practice address
1934 NW MAIN ST, DECATUR, IN 46733-8766
(260) 701-1934
(260) 724-2511
Mailing address
1934 NW MAIN ST, DECATUR, IN 46733-8766
(260) 701-1934
(260) 724-2511
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
IN
Other
Enumeration date
11/12/2006
Last updated
08/22/2020
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