| New Outlook.. Second Chance, Inc. | |
|
4801 E Independence Blvd Suite 501 Charlotte NC 28212-5400 | |
| (980) 226-5528 | |
| Not Available |
| Full Name | New Outlook.. Second Chance, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4801 E Independence Blvd, Charlotte, North Carolina |
| Authorized Official Name and Position | Bethena M Jackson (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9196824771 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Outlook.. Second Chance, Inc. 331 W Main St Suite 302-306 Durham NC 27701-3232 Ph: (919) 682-4771 | New Outlook.. Second Chance, Inc. 4801 E Independence Blvd Suite 501 Charlotte NC 28212-5400 Ph: (980) 226-5528 |
| NPI Number | 1568691921 |
|---|---|
| Provider Enumeration Date | 07/07/2009 |
| Last Update Date | 07/07/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568691921 | NPI | - | NPPES |
| 8302362B | Medicaid | NC | |
| 8700391 | Medicaid | NC | |
| 8302362G | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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