Organization
SECOND CHANCE ADDICTION CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHERYL ANN MOORE LCSW-C (CLINICAL DIRECTOR)
(240) 723-5018
Entity
Organization
Contact information
Practice address
401 E JEFFERSON ST STE 203, ROCKVILLE, MD 20850-2617
(301) 983-5130
(855) 270-6701
Mailing address
9800 FALLS RD STE 7, POTOMAC, MD 20854-3942
(301) 983-5130
(855) 270-6701
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500320200
—
MD
Enumeration date
06/15/2023
Last updated
06/15/2023
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