Organization
FRESH START COMMUNITY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TONYA C TATE MS (CEO/OWNER)
(601) 954-2421
Entity
Organization
Contact information
Practice address
152 EDWARD OWENS DR, TERRY, MS 39170-8921
(601) 954-2421
Mailing address
152 EDWARD OWENS DR, TERRY, MS 39170-8921
(601) 954-2421
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
172V00000X
Community Health Worker
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
03/03/2015
Last updated
03/03/2015
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