Organization · NPI-2

2nd Chance Mental Health Center, LLC

Social Worker, Clinical · Port St Lucie, FL

NPI number1942518246
StatusActive
Last updated in NPPESMay 6, 2013

Details

NPI
1942518246
Entity type
Organization (NPI-2)
Legal business name
2nd Chance Mental Health Center, LLC
Organization subpart
No
Enumeration date
Sep 21, 2010
Last updated
May 6, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, ClinicalSW9510FLYes

Practice location

1541 Se Port St Lucie Blvd
Suite F
Port St Lucie, FL 34952-5456

Phone 772-335-0166

Mailing address

1541 Se Port St Lucie Blvd
Suite F
Port St Lucie, FL 34952-5456

Phone 772-335-0166

Authorized official

Johnny Brown
Ceo/Owner
7723350166

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