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Organization

MIRACLES OF A SECOND CHANCE INC

Active
Other names
MIRACLES OF A SECOND CHANCE INC
Organization subpart
No

Provider details

NPI number
Authorized official
ANGELA SAAVEDRA RN (PRESIDENT/CEO)
(520) 255-2158
Entity
Organization

Contact information

Practice address
507 19TH TER, BISBEE, AZ 85603-1705
(520) 255-2158
Mailing address
415 BERNINI AVE, SIERRA VISTA, AZ 85635-2369
(520) 456-6062

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YP1600X
Pastoral Counselor
106S00000X
Behavior Technician
133V00000X
Registered Dietitian
163W00000X
Registered Nurse
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
207QA0505X
Adult Medicine Physician
324500000X
Substance Abuse Rehabilitation Facility
Primary
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1518503945
AZ
05
1962572008
AZ
Enumeration date
01/31/2024
Last updated
09/11/2024
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