Organization
NEW OUTLOOK SECOND CHANCE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BETHENA MECHELE JACKSON MA,LCAS-A (EXECUTIVE DIRECTOR)
(919) 682-4771
Entity
Organization
Contact information
Practice address
2604 CARVER ST, SUITE C, DURHAM, NC 27705-2796
(919) 682-4771
(919) 683-2641
Mailing address
2604 CARVER ST, SUITE C, DURHAM, NC 27705-2796
(919) 682-4771
(919) 683-2641
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
632008
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8700391
—
NC
Enumeration date
12/28/2006
Last updated
10/08/2012
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