Fresh Start Dialysis Spa Treatment Center

NPI #1821220138 in Largo, Maryland

Provider Information

NPI Number: 1821220138
Entity Type: Organization
Organization Name: Fresh Start Dialysis Spa Treatment Center
Primary Specialty: Clinic/Center
Enumeration Date: Aug 20, 2009
Last Updated: Aug 20, 2009

Practice Location

Address: 1101 MERCANTILE LN
City: Largo
State: Maryland
ZIP Code: 20774-5360
Phone: (240) 606-7828

Authorized Official

Name: MS. TAHISHA B. BROOKS
Title: PRESIDENT & CEO
Phone: (240) 606-7828

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X
Counselor - Mental Health — Mental Health	101YM0800X
Nutritionist - Nutrition, Education — Nutrition, Education	133NN1002X
Dietitian, Registered - Nutrition, Renal — Nutrition, Renal	133VN1005X
Driver	172A00000X
Massage Therapist	225700000X
Clinic/Center	261Q00000X	Primary

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