Organization
A FRESH START RECOVERY HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REEIYAINA GRIFFIN (AGENT)
(414) 815-0505
Entity
Organization
Contact information
Practice address
3505 W. NORTH AVENUE, MILWAUKEE, WI 53208
(414) 600-9947
Mailing address
PO BOX 12773, MILWAUKEE, WI 53212
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
02/22/2022
Last updated
02/24/2022
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