Fresh Start Private Florida | |
1415 Panther Ln Naples FL 34109-7874 | |
(239) 591-6240 | |
Not Available |
Full Name | Fresh Start Private Florida |
---|---|
Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
Location | 1415 Panther Ln, Naples, Florida |
Authorized Official Name and Position | Timothy Jon Jackoboice (CEO) |
Authorized Official Contact | 2395916240 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Fresh Start Private Florida 1415 Panther Ln Naples FL 34109-7874 Ph: (239) 591-6240 | Fresh Start Private Florida 1415 Panther Ln Naples FL 34109-7874 Ph: (239) 591-6240 |
NPI Number | 1003166307 |
---|---|
Provider Enumeration Date | 09/13/2012 |
Last Update Date | 09/13/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003166307 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
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