2nd Chance 2 LLC
Community/Behavioral Health in Winston Salem, NC. Organization (NPI-2).
NPI number1053139790
StatusActive
Last updated in NPPESOct 1, 2024
Details
- NPI
- 1053139790
- Entity type
- Organization (NPI-2)
- Legal business name
- 2nd Chance 2 LLC
- Organization subpart
- No
- Enumeration date
- Oct 1, 2024
- Certification date
- Sep 30, 2024
- Last updated
- Oct 1, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
| 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – | |
| 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – |
Other names
- 2nd Chance (Other Name)
Practice location
2704 Bon Air AveWinston Salem, NC 27105-4307
Phone 336-972-4487
Mailing address
1856 Old Hollow RdWalkertown, NC 27051-9716
Phone 336-767-6535
Authorized official
Julian Belton
Owner/President
3365757582
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