OrganizationActive
A Fresh Start and New Beginnings
NPI 1316237076 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Glendale, AZ
Provider details
- NPI number
- 1316237076
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Authorized official
- Beverly Bailey, Ceo
- License
- BH3871 (AZ)
Practice location
4105 W Villa Linda Dr
Glendale, AZ 85310-5157
Phone: (623) 434-2126
Fax: (623) 434-1494
Mailing address
4105 W Villa Linda Dr
Glendale, AZ 85310-5157
Registry dates
- Enumerated
- 2011-04-15
- Last updated
- 2011-07-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.