Organization
2ND CHANCE 2 LLC
Active
Other names
2nd chance
Organization subpart
No
Provider details
NPI number
Authorized official
JULIAN BELTON (OWNER/PRESIDENT)
(336) 575-7582
Entity
Organization
Contact information
Practice address
2704 BON AIR AVE, WINSTON SALEM, NC 27105-4307
(336) 972-4487
Mailing address
1856 OLD HOLLOW RD, WALKERTOWN, NC 27051-9716
(336) 767-6535
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
10/01/2024
Last updated
10/01/2024
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