SECOND CHANCE (NPI# 1780133363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780133363 |
| Entity Type | Organization |
| Organization Name | SECOND CHANCE |
| Practice Address |
1428 Desert Ridge Ave North Las Vegas NV 89031-5003 |
| Practice Telephone | 7028090993 |
| Mailing Telephone | 7028090993 |
| Enumeration Date | 2016-09-24 |
| Last Update Date | 2016-09-24 |
| Authorized Official Name | MAHOGANY J BOYD (OWNER) |
| Authorized Official Telephone | 7028090993 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | NV20161565425 | NV | Agencies |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SECOND CHANCE | 600 Tracy Rd, Whiteland, IN 46184-9698 |
| New York State Corporations | SECOND CHANCE | 95 Niagara Falls Blvd., Buffalo, New York 14214 |
| Washington State Corporations | SECOND CHANCE 100 | 422 W Titus St, Kent, WA 98032 |
| Indiana Business Entities | SECOND CHANCE 4 U LIMITED LIABILITY COMPANY | 6400 Central Ave, Portage, IN 46368 |
| System for Award Management (SAM) Entities | SECOND CHANCE 4 YOUTH INITIATIVE | 1155 E Sunset Dunes Way, Draper, UT 84020-5676 |
| System for Award Management (SAM) Entities | SECOND CHANCE 444 INCORPORATED | 5134 Middleton View Dr, Myrtle Beach, SC 29579-8518 |
| Indiana Business Entities | SECOND CHANCE ABUSE RECOVERY SERVICES PIT BULL RESCUE, INC. (S.C.A.R.S.) | 103 N. Lindsay, Claypool, IN 46510 |
| Colorado Business Entities | second chance accessibility plus. ltd | 3280 N. Downing St, Apt 316, Denver, CO 80205 |
| New York State Corporations | SECOND CHANCE ACQUISITIONS, INC. | 600 Harlem Road, West Seneca, Ny 14224 |
| Ohio Business Entities | SECOND CHANCE ACRES INC | 382 Township Road 1101, Nova, OH 44859 |
| Street Address |
1428 DESERT RIDGE AVE |
| City | NORTH LAS VEGAS |
| State | NV |
| Zip Code | 89031-5003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144772724 | Brandy Hinton | Community Health Worker | 1428 Desert Ridge Ave, North Las Vegas, NV 89031-5003 | 2016-10-28 |
| 1629527817 | Zephra Jackson | Community/Behavioral Health | 1428 Desert Ridge Ave, North Las Vegas, NV 89031-5003 | 2016-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265071039 | Dimuro Facilities Services | Pain Medicine | Dimuro Pain Management, 3970 W Ann Road Ste 100, N Las Vegas, NV 89031 | 2019-12-27 |
| 1225681323 | Jasmine Coleman | Home Health Aide | 1517 Santa Rosalia Dr., North Las Vegas, NV 89031 | 2019-07-18 |
| 1558924134 | Jamie Esprecion | Driver | 3007 Extravagant Ave, North Las Vegas, NV 89031 | 2019-04-18 |
| 1831652387 | Assured Medical Supply, Inc. | Durable Medical Equipment & Medical Supplies | 4461 North Decatur Blvd, Ste 110, N Las Vegas, NV 89031 | 2019-04-11 |
| 1265928550 | Geraldine Alford | Chore Provider | 5150 El Camino Norte Suite 150, Las Vegas, NV 89031 | 2018-07-10 |
| 1861999468 | Danielle Anderson | Counselor | 4528 West Craig Suite 150, Las Vegas, NV 89031 | 2018-04-10 |
| 1871094078 | Ethel Richardson | Chore Provider | 620 Manuel Edwardo Ave, N. Las Vegas, NV 89031 | 2018-02-22 |
| 1124547997 | Crystal Dorin Mcdowell | Counselor | 5920 Palmilla St Unit 5, North Las Vegas, NV 89031 | 2017-09-13 |
| 1699293308 | Mitzi Darnell Adeyemi | Counselor | 2205 Mountain Sunset Ave, North Las Vegas, NV 89031 | 2017-09-01 |
| 1831629500 | Emily Davis | Case Manager/Care Coordinator | 1926 La Villa Dr, North Las Vegas, NV 89031 | 2017-06-15 |
| Find all providers in zip 89031 | ||||
| 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 |
|---|---|---|---|---|
| 1164020947 | Pathways Health Services | Community/Behavioral Health | 5813 Michael Dean St, North Las Vegas, NV 89081-4422 | 2020-10-13 |
| 1386241131 | Shawn Humphreys | Community/Behavioral Health | 3110 W Cheyenne Ave Ste 100, North Las Vegas, NV 89032-2254 | 2020-10-05 |
| 1013514165 | Grateful Guidance Center | Community/Behavioral Health | 1838 Giant Rock Pl, North Las Vegas, NV 89031-1671 | 2020-10-01 |
| 1447861919 | A Step Above Mental Health Services LLC | Community/Behavioral Health | 4325 W Rome Blvd Apt 1018, North Las Vegas, NV 89084-2112 | 2020-08-10 |
| 1023628047 | Essential Mindz, LLC | Community/Behavioral Health | 5546 Camino Al Norte Ste 2-304, North Las Vegas, NV 89031-0805 | 2020-08-04 |
| 1558985432 | 4 Lucky Charms LLC | Community/Behavioral Health | 4224 Seclusion Bay Ave, North Las Vegas, NV 89081-6867 | 2020-06-05 |
| 1952936296 | All Around Change LLC | Community/Behavioral Health | 2124 Leatherbridge Ct, North Las Vegas, NV 89081-3500 | 2020-03-06 |
| 1457985962 | Khalifah Holdings Incorporated | Community/Behavioral Health | 2616 Losee Rd Ste 11, North Las Vegas, NV 89030-4128 | 2020-02-24 |
| 1366075798 | We R Family, LLC | Community/Behavioral Health | 2312 Seco Adobe Cir Apt B, North Las Vegas, NV 89030-8182 | 2020-02-13 |
| 1497397301 | Press On LLC | Community/Behavioral Health | 5712 Saint Elias St, North Las Vegas, NV 89081-2427 | 2019-10-11 |
| Find all providers in NORTH LAS VEGAS | ||||
| City | NORTH LAS VEGAS |
| Zip Code | 89031 |
Please comment or provide details below to improve the information on SECOND CHANCE.
| 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.