Organization
SECOND CHANCE GROUP HOME INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICKY LAMAR ROBERSON (OWNER)
(352) 396-1247
Entity
Organization
Contact information
Practice address
4548 POWDERHORN PLACE DR, CLERMONT, FL 34711-8940
(352) 396-1247
(352) 394-2353
Mailing address
4548 POWDERHORN PLACE DR, CLERMONT, FL 34711-8940
(352) 396-1247
(352) 394-2353
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/26/2022
Last updated
01/26/2022
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