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Organization

2ND CHANCE MENTAL HEALTH CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEAN M LARSEN MSW (PRESIDENT)
(772) 249-0880
Entity
Organization

Contact information

Practice address
1250 SE PORT ST LUCIE BLVD STE C, PORT SAINT LUCIE, FL 34952-5385
(772) 249-0880
(772) 249-0881
Mailing address
1250 SE PORT ST LUCIE BLVD STE C, PORT SAINT LUCIE, FL 34952-5385
(772) 249-0880
(772) 249-0881

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1956AD422201
FL

Other

Enumeration date
12/22/2010
Last updated
12/22/2010
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