Organization
START FRESH ALCOHOL RECOVERY CLINIC, INC
Active
Other names
Start Fresh Recovery Las Vegas
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE N FALLIERAS M.D. (PRESIDENT)
(702) 919-0000
Entity
Organization
Contact information
Practice address
501 S RANCHO DR STE H50, LAS VEGAS, NV 89106-4828
(702) 919-0000
(702) 476-9411
Mailing address
501 S RANCHO DR STE H50, LAS VEGAS, NV 89106-4828
(702) 919-0000
(702) 476-9411
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
15522
NV
261QR0800X
Recovery Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15522
STATE LICENSE
NV
Enumeration date
10/24/2014
Last updated
10/24/2014
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