| Second Chance Phoenix Women's Program | |
|
6330 Thornton Ave Suite A Newark CA 94560-3734 | |
| (510) 745-1675 | |
| Not Available |
| Full Name | Second Chance Phoenix Women's Program |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6330 Thornton Ave, Newark, California |
| Authorized Official Name and Position | Jimmy L Rogers (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5107451675 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Second Chance Phoenix Women's Program 6330 Thornton Ave Suite A Newark CA 94560-3734 Ph: (510) 745-1675 | Second Chance Phoenix Women's Program 6330 Thornton Ave Suite A Newark CA 94560-3734 Ph: (510) 745-1675 |
| NPI Number | 1265600472 |
|---|---|
| Provider Enumeration Date | 02/11/2008 |
| Last Update Date | 09/10/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265600472 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 018060 (California) | Primary |
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