# 2ND CHANCE AT LIFE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730692252
- **Authorized official:** NATHALIE R GILLES (MANAGER)
- **Authorized official phone:** (239) 270-9745

## Contact information

- **Practice address:** 10425 NW 2ND CT, MIAMI, FL 33150-1128
- **Practice address phone:** (786) 281-2086
- **Mailing address:** 5711 NW 21ST ST APT 18B, LAUDERHILL, FL 33313-3108
- **Mailing address phone:** (239) 270-9745

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | FL | Yes |

## Other

- **Enumeration date:** 11/06/2017
- **Last updated:** 11/06/2017