Organization
START FRESH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SAMANTHA SAU YU FUNG CSAC, LCSW (OWNER)
(808) 232-4768
Entity
Organization
Contact information
Practice address
98-211 PALI MOMI ST STE 635, AIEA, HI 96701-4322
(808) 232-4768
Mailing address
1315 KALAKAUA AVE APT 907, HONOLULU, HI 96826-1943
(808) 232-4768
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
CSAC 1809-14
HI
251S00000X
Community/Behavioral Health Agency
Primary
LCSW-3958
HI
Other
Enumeration date
08/29/2014
Last updated
09/22/2014
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