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Organization
SECOND CHANCE SLE
Active
Organization
SECOND CHANCE SLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK ROBERT MCCONVILLE (EXECUTIVE DIRECTOR)
(510) 792-4357
Entity
Organization
Contact information
Practice address
6448 BROADWAY AVE, NEWARK, CA 94560-4012
(510) 792-4357
(510) 745-1693
Mailing address
PO BOX 643, NEWARK, CA 94560-0643
(510) 792-4357
(510) 745-7693
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/21/2008
Last updated
02/21/2008
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