Fresh New Start LLC

NPI #1467633081 in Decatur, Indiana

Provider Information

NPI Number: 1467633081
Entity Type: Organization
Organization Name: Fresh New Start LLC
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Nov 26, 2007
Last Updated: Nov 26, 2007

Practice Location

Address: 1934 NW MAIN ST
City: Decatur
State: Indiana
ZIP Code: 46733-8766
Phone: (260) 724-2511

Authorized Official

Name: MRS. SHARLENE KAY WETENDORF
Title: OWNER
Phone: (260) 724-2511

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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