| Second Chance Addiction Care | |
|
401 E Jefferson St Ste 203 Rockville MD 20850-2617 | |
| (301) 983-5130 | |
| (855) 270-6701 |
| Full Name | Second Chance Addiction Care |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 401 E Jefferson St Ste 203, Rockville, Maryland |
| Authorized Official Name and Position | Cheryl Ann Moore (CLINICAL DIRECTOR) |
| Authorized Official Contact | 2407235018 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Second Chance Addiction Care 9800 Falls Rd Ste 7 Potomac MD 20854-3942 Ph: (301) 983-5130 | Second Chance Addiction Care 401 E Jefferson St Ste 203 Rockville MD 20850-2617 Ph: (301) 983-5130 |
| NPI Number | 1124703418 |
|---|---|
| Provider Enumeration Date | 06/15/2023 |
| Last Update Date | 06/15/2023 |
| Certification Date | 06/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124703418 | NPI | - | NPPES |
| 500320200 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Primary |
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