Organization
SECOND CHANCE YOUTH COMMUNITY CENTER INC
Active
Other names
Second Chance Social Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIRLINE LOZISPOLYNICE PHD (CEO)
(678) 468-9295
Entity
Organization
Contact information
Practice address
3303 SALEM RD, COVINGTON, GA 30016-1865
(978) 219-3577
(770) 267-3248
Mailing address
2899 H D ATHA RD, COVINGTON, GA 30014-0728
(678) 468-9295
(770) 267-3248
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
07088392
GA
Other
Enumeration date
09/20/2013
Last updated
09/20/2013
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