Organization
L.I.M.S.
Active
Other names
1st & 2nd Chance Adult Care Services Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARON EDWARDS BERRYMAN (OWNER)
(980) 307-6222
Entity
Organization
Contact information
Practice address
401 JACKSON PARK RD, KANNAPOLIS, NC 28083-3655
(980) 307-6222
(704) 454-7349
Mailing address
401 JACKSON PARK RD, KANNAPOLIS, NC 28083-3655
(980) 307-6222
(704) 454-7349
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
MH-013177
NC
261QM0850X
Adult Mental Health Clinic/Center
Primary
MHL-013-176
NC
Other
Enumeration date
01/08/2014
Last updated
01/08/2014
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