Organization · NPI-2
2nd Chance Rediscovery
Community/Behavioral Health · Bishop, CA
NPI number1629704184
StatusActive
Last updated in NPPESJul 27, 2022
Details
- NPI
- 1629704184
- Entity type
- Organization (NPI-2)
- Legal business name
- 2nd Chance Rediscovery
- Organization subpart
- Yes
- Enumeration date
- Jul 27, 2022
- Certification date
- Apr 11, 2022
- Last updated
- Jul 27, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
| 101YP1600X | Counselor, Pastoral | – | – | |
| 251B00000X | Case Management | – | – | |
| 1744G0900X | Specialist, Graphics Designer | – | – |
Practice location
1851 Shoshone DrBishop, CA 93514-8115
Phone 171-447-8204
Mailing address
1851 Shoshone DrBishop, CA 93514-8115
Phone 171-447-8204
Authorized official
Kaitlin Elizabeth Crom
Executive Director
7144782044
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