Organization
SECOND CHANCE HEALTH & WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEVIN FOSTER (CEC/FOUNDER)
(601) 842-4718
Entity
Organization
Contact information
Practice address
11 NORTHTOWN DR STE 225, JACKSON, MS 39211-3698
(601) 842-4718
Mailing address
15 OAKFORD CT, JACKSON, MS 39211-3050
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
261QF0050X
Non-Surgical Family Planning Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QS1000X
Student Health Clinic/Center
—
—
Other
Enumeration date
01/16/2025
Last updated
01/16/2025
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