Organization
2ND CHANCE ADVANCEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTONIO LAJUAN BRADLEY (OWNER)
(804) 503-9828
Entity
Organization
Contact information
Practice address
509 LOCK LN, PETERSBURG, VA 23805-2542
(804) 503-9828
Mailing address
509 LOCK LN, PETERSBURG, VA 23805-2542
(804) 503-9828
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
08/28/2023
Last updated
08/28/2023
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