Basic Information
| Provider Information | |||||||||
| NPI: | 1194239269 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | A NEW START - FLORIDA, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 222 PHILLIP STONE WAY | ||||||||
| Address2: | |||||||||
| City: | CENTRAL CITY | ||||||||
| State: | KY | ||||||||
| PostalCode: | 423301929 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707543494 | ||||||||
| FaxNumber: | 2707543499 | ||||||||
| Practice Location | |||||||||
| Address1: | 1514 S ALEXANDER ST STE 202 | ||||||||
| Address2: | |||||||||
| City: | PLANT CITY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335638418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8134414757 | ||||||||
| FaxNumber: | 8134414968 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/27/2017 | ||||||||
| LastUpdateDate: | 11/27/2017 | ||||||||
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| AuthorizedOfficialLastName: | EDWARDS | ||||||||
| AuthorizedOfficialFirstName: | LOIS | ||||||||
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| AuthorizedOfficialTitleorPosition: | OPERATIONS OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 2707543494 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0405X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
No ID Information.