Organization
FRESH START LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY MEADE CDP (OWNER/OPERATOR)
36097844186
Entity
Organization
Contact information
Practice address
1752 STATE HWY 508, ONALASKA, WA 98570
(360) 978-4186
(360) 978-4186
Mailing address
PO BOX 485, ONALASKA, WA 98570-0485
(360) 978-4186
(360) 978-4186
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
CP00005297
WA
251S00000X
Community/Behavioral Health Agency
Primary
RC00047372
WA
Other
Enumeration date
11/17/2009
Last updated
11/17/2009
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