Fresh Start Community Services, LLC

NPI #1417349150 in Terry, Mississippi

Provider Information

NPI Number: 1417349150
Entity Type: Organization
Organization Name: Fresh Start Community Services, LLC
Primary Specialty: Counselor
Enumeration Date: Mar 3, 2015
Last Updated: Mar 3, 2015

Practice Location

Address: 152 EDWARD OWENS DR
City: Terry
State: Mississippi
ZIP Code: 39170-8921
Phone: (601) 954-2421

Authorized Official

Name: MRS. TONYA C TATE, MS
Title: CEO/OWNER
Phone: (601) 954-2421

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Health Worker	172V00000X
Community/Behavioral Health	251S00000X
Counselor	101Y00000X	Primary

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