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Organization
SECOND CHANCE DAYTON GROUP HOME
Active
Organization
SECOND CHANCE DAYTON GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARQUITA SHENAE DAVIS (DIRECTOR)
(937) 248-5162
Entity
Organization
Contact information
Practice address
1358 CANFIELD AVE, DAYTON, OH 45406-4309
(937) 248-5162
Mailing address
7010 HERCULES WAY, WAYNESVILLE, OH 45068-7505
(937) 248-5162
(937) 701-6898
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
01/31/2023
Last updated
08/27/2026
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