| New Outlook..second Chance, Inc. | |
|
976 Martin Luther King Jr Blvd Suite 206 Chapel Hill NC 27514-2654 | |
| (919) 633-8360 | |
| (919) 683-2641 |
| Full Name | New Outlook..second Chance, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 976 Martin Luther King Jr Blvd, Chapel Hill, North Carolina |
| Authorized Official Name and Position | Bethena M Jackosn (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. 930 Martin Luther King Jr Blvd Suite 206 Chapel Hill NC 27514-2656 Ph: (919) 633-8360 | New Outlook..second Chance, Inc. 976 Martin Luther King Jr Blvd Suite 206 Chapel Hill NC 27514-2654 Ph: (919) 633-8360 |
| NPI Number | 1386975548 |
|---|---|
| Provider Enumeration Date | 01/27/2010 |
| Last Update Date | 05/11/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386975548 | NPI | - | NPPES |
| 8302362G | Medicaid | NC | |
| 8700391 | Medicaid | NC | |
| 8302362B | Medicaid | NC | |
| 8302703G | Medicaid | NC | |
| 8302703B | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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