Provider Demographics
NPI:1326895269
Name:FRESH START RECOVERY
Entity type:Organization
Organization Name:FRESH START RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARKAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:CADC ,CRM ,PSS, QMHA
Authorized Official - Phone:971-478-5098
Mailing Address - Street 1:355 NW 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-4176
Mailing Address - Country:US
Mailing Address - Phone:971-468-5098
Mailing Address - Fax:
Practice Address - Street 1:355 NW 6TH AVE APT 703
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-4175
Practice Address - Country:US
Practice Address - Phone:971-468-5098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESH START RECOVERY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty