| Second Chance, Llc | |
|
315 Hospital Dr Ste 105 Martinsville VA 24112-1927 | |
| (276) 201-9506 | |
| Not Available |
| Full Name | Second Chance, Llc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 315 Hospital Dr Ste 105, Martinsville, Virginia |
| Authorized Official Name and Position | Lisa Mcintosh (LPC) |
| Authorized Official Contact | 7573209331 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Second Chance, Llc Po Box 3699 Martinsville VA 24115-3699 Ph: (757) 320-9331 | Second Chance, Llc 315 Hospital Dr Ste 105 Martinsville VA 24112-1927 Ph: (276) 201-9506 |
| NPI Number | 1194325191 |
|---|---|
| Provider Enumeration Date | 10/28/2020 |
| Last Update Date | 10/28/2020 |
| Certification Date | 10/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194325191 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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