Organization
SECOND CHANCE FOR YOU
Active
Other names
Second Chance 4 Kidz
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KERTRENIA S JONES (OWNER)
(704) 807-5910
Entity
Organization
Contact information
Practice address
1526 PEACHCROFT RD, CHARLOTTE, NC 28216-2747
(704) 231-2889
Mailing address
2213 SOUTHWIND DR, CHARLOTTE, NC 28216-8846
(704) 231-2889
(704) 971-0131
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
0601002
NC
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
0601002
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805669
—
NC
Enumeration date
08/29/2007
Last updated
08/29/2007
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