Organization
FRESH START RESIDENTIAL FACILITY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEMONTAY RAMEL MUNFORD (DIRECTOR)
(910) 867-3591
Entity
Organization
Contact information
Practice address
7866 ADRIAN DR, FAYETTEVILLE, NC 28314-6312
(910) 867-3591
Mailing address
7866 ADRIAN DR, FAYETTEVILLE, NC 28314-6312
(910) 867-3591
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
026-822
NC
Other
Enumeration date
01/17/2007
Last updated
08/20/2014
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