SECOND CHANCE YOUTH COMMUNITY CENTER INC (NPI# 1023444197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023444197 |
| Entity Type | Organization |
| Organization Name | SECOND CHANCE YOUTH COMMUNITY CENTER INC |
| Other Organization Name | SECOND CHANCE SOCIAL SERVICES |
| Practice Address |
3303 Salem Rd Covington GA 30016-1865 |
| Mailing Address |
2899 H D Atha Rd Covington GA 30014-0728 |
| Practice Telephone | 9782193577 |
| Practice Fax Number | 7702673248 |
| Mailing Telephone | 6784689295 |
| Mailing Fax Number | 7702673248 |
| Enumeration Date | 2013-09-20 |
| Last Update Date | 2013-09-20 |
| Authorized Official Name | DR. MIRLINE LOZISPOLYNICE (CEO) |
| Authorized Official Telephone | 6784689295 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 07088392 | GA | Agencies |
| Other Name | Type Code |
|---|---|
| Second Chance Social Services | Other Name - Individual/Organization |
| Street Address |
3303 SALEM RD |
| City | COVINGTON |
| State | GA |
| Zip Code | 30016-1865 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013565605 | Katrina Williams | Case Manager/Care Coordinator | 220 Meadowidge Dr, Covington, GA 30016 | 2019-08-28 |
| 1407322134 | Mali Rice | Registered Nurse | 105 Syracuse Lane, Covington, GA 30016 | 2018-10-20 |
| 1619452927 | Angelina Jones | Contractor | 290 Piedmont Circle, Covington, GA 30016 | 2018-10-02 |
| 1881116721 | Springhill Manor Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 600 Spring Hill Drive, Covington, GA 30016 | 2017-07-12 |
| 1922538529 | Tisha Owes | Home Health | 110 Trinity Dr, Covington, GA 30016 | 2017-06-15 |
| 1053868695 | Delhia Assanah IIi | Counselor | 101 Kirkland Road, Covington, GA 30016 | 2016-09-01 |
| 1760834295 | Resurgens East Surgery Center, LLC | Clinic/Center | 3241 Iris Dr, Suite 100, Covington, GA 30016 | 2016-07-08 |
| 1528443371 | Latoya N Wright | Counselor | 100 Winnstead Place, Covington, GA 30016 | 2015-07-22 |
| 1598157307 | Sierra Private Homecare, Inc. | Adult Companion | 75 Cinnamon Oak Circle, Covington, GA 30016 | 2015-03-03 |
| 1326391079 | Lana Abiola Fraser | Nurse's Aide | 840 Oakhill Road, Covington, GA 30016 | 2012-10-18 |
| Find all providers in zip 30016 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497314900 | Raymir Behavioral Health LLC | Community/Behavioral Health | 2899 H D Atha Rd, Covington, GA 30014-0728 | 2019-06-08 |
| 1730547977 | Paragon Wellness, LLC | Community/Behavioral Health | 726 E Rutland St, Covington, LA 70433-3223 | 2016-02-02 |
| 1396136933 | Tchefuncte Family Counseling | Community/Behavioral Health | 321 N Vermont St, Suite 203, Covington, LA 70433-2833 | 2015-02-17 |
| 1780087007 | Parr Educational Evaluations, LLC | Community/Behavioral Health | 5001 Hwy190, Suite B, Covington, LA 70433 | 2014-10-01 |
| 1821497603 | Around Atlanta Psychotherapy Concepts, LLC | Community/Behavioral Health | 580 Clearbrook Dr, Covington, GA 30016-9134 | 2014-08-18 |
| 1902249485 | Family Preservation Services, Inc. | Community/Behavioral Health | 4050 Midland Trl, Covington, VA 24426-5403 | 2013-04-15 |
| 1831532431 | Family Preservation Services, Inc. | Community/Behavioral Health | 100 Gleason Dr, Covington, VA 24426-6246 | 2013-04-12 |
| 1730522335 | Family Preservation Services, Inc. | Community/Behavioral Health | 1000 Riverview Farm Rd, Covington, VA 24426-6245 | 2013-04-12 |
| 1215294137 | Scholar Specialized Treatment Services | Community/Behavioral Health | 45 Wellstone Pl, Covington, GA 30014-7076 | 2012-04-17 |
| 1538445176 | Youth Service Bureau of St Tammany | Community/Behavioral Health | 430 N New Hampshire St, Covington, LA 70433-2830 | 2011-10-27 |
| Find all providers in COVINGTON | ||||
Please comment or provide details below to improve the information on SECOND CHANCE YOUTH COMMUNITY CENTER INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.