Organization
SECOND CHANCES PEER SUPPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBONY KEITH KEITH (CFO)
(704) 299-2825
Entity
Organization
Contact information
Practice address
3226 LILAC GROVE DR, CHARLOTTE, NC 28269-0652
(704) 299-2825
(704) 299-2825
Mailing address
3226 LILAC GROVE DR, CHARLOTTE, NC 28269-0652
(704) 299-2825
(704) 299-2825
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/22/2026
Last updated
04/22/2026
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