Organization
FRESH START OUTREACH MINISTRIES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLAY RUSSELL LAC CCS (EXECUTIVE DIRECTOR)
(318) 805-4775
Entity
Organization
Contact information
Practice address
7060 PRAIRIE RD, WINNSBORO, LA 71295-2951
(318) 435-7061
(318) 435-7063
Mailing address
7060 PRAIRIE RD, WINNSBORO, LA 71295-2951
(318) 435-7061
(318) 435-7063
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
02/06/2023
Last updated
02/06/2023
Update your record
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