Organization
SECOND CHANCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MCINTOSH (LPC)
(757) 320-9331
Entity
Organization
Contact information
Practice address
315 HOSPITAL DR STE 105, MARTINSVILLE, VA 24112-1927
(276) 201-9506
Mailing address
PO BOX 3699, MARTINSVILLE, VA 24115-3699
(757) 320-9331
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/28/2020
Last updated
10/28/2020
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