Organization
2ND CHANCE AT LIFE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHALIE R GILLES (MANAGER)
(239) 270-9745
Entity
Organization
Contact information
Practice address
10425 NW 2ND CT, MIAMI, FL 33150-1128
(786) 281-2086
Mailing address
5711 NW 21ST ST APT 18B, LAUDERHILL, FL 33313-3108
(239) 270-9745
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
FL
Other
Enumeration date
11/06/2017
Last updated
11/06/2017
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