Organization · NPI-2

2nd Chance At Life, LLC

Counselor, Addiction (Substance Use Disorder) · Miami, FL

NPI number1730692252
StatusActive
Last updated in NPPESNov 6, 2017

Details

NPI
1730692252
Entity type
Organization (NPI-2)
Legal business name
2nd Chance At Life, LLC
Organization subpart
No
Enumeration date
Nov 6, 2017
Last updated
Nov 6, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YA0400X Counselor, Addiction (Substance Use Disorder)–FLYes

Practice location

10425 Nw 2nd Ct
Miami, FL 33150-1128

Phone 786-281-2086

Mailing address

5711 Nw 21st St Apt 18b
Lauderhill, FL 33313-3108

Phone 239-270-9745

Authorized official

Nathalie R Gilles
Manager
2392709745

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