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Organization
SECOND CHANCE ASHLAND CENTER
Active
Organization
SECOND CHANCE ASHLAND CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK R MCCONVILLE (EXECUTIVE DIRECTOR)
(510) 792-4357
Entity
Organization
Contact information
Practice address
1403 164TH AVE, SAN LEANDRO, CA 94578-3123
(510) 481-8645
(510) 481-2413
Mailing address
1403 164TH AVE, SAN LEANDRO, CA 94578-3123
(510) 481-8645
(510) 481-2413
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0119
CA
Other
Enumeration date
06/04/2007
Last updated
08/22/2020
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