Provider Demographics
NPI:1417771320
Name:FRESH START HOLDINGS LLC
Entity type:Organization
Organization Name:FRESH START HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-800-6922
Mailing Address - Street 1:7901 PAINTER AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-2469
Mailing Address - Country:US
Mailing Address - Phone:562-800-6922
Mailing Address - Fax:562-800-3214
Practice Address - Street 1:7901 PAINTER AVE STE 1
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-2469
Practice Address - Country:US
Practice Address - Phone:562-800-6922
Practice Address - Fax:562-800-3214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No174200000XOther Service ProvidersMeals
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care