Organization
FRESH START OUTREACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELTON FRESHWATER (OWNER)
(804) 380-0181
Entity
Organization
Contact information
Practice address
1830 RUFFIN MILL CIR STE B, SOUTH CHESTERFIELD, VA 23834-5927
(804) 380-0181
Mailing address
1830 RUFFIN MILL CIR STE B, SOUTH CHESTERFIELD, VA 23834-5927
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
02/05/2024
Last updated
07/30/2024
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