Organization
SECOND CHANCES CM, LLC
Active
Other names
Second Chances
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL MARANTIS (OWNER)
(330) 502-8051
Entity
Organization
Contact information
Practice address
16687 SAINT CLAIR AVE, SUITE 202, EAST LIVERPOOL, OH 43920-9401
(330) 398-1076
Mailing address
16687 SAINT CLAIR AVE, SUITE 202, EAST LIVERPOOL, OH 43920-9401
(330) 398-1076
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
208D00000X
General Practice Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Enumeration date
12/28/2015
Last updated
06/27/2016
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