Organization
SECOND CHANCE LIVING SUPPORTIVE SERVICES
Active
Other names
SCL Supportive Services
Organization subpart
No
Provider details
NPI number
Authorized official
DARREN KILGORE (EXECUTIVE DORECTOR)
(248) 313-4775
Entity
Organization
Contact information
Practice address
3031 W GRAND BLVD STE 522, DETROIT, MI 48202-3187
(248) 313-4775
(313) 566-9229
Mailing address
269 WALKER ST, SUITE 538, DETROIT, MI 48207-4258
(313) 610-0134
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
05/08/2014
Last updated
05/03/2024
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