SECOND CHANCES YOUTH SERVICES, LLC (NPI# 1831420660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831420660 |
| Entity Type | Organization |
| Organization Name | SECOND CHANCES YOUTH SERVICES, LLC |
| Practice Address |
2002 Wakefield Ave Petersburg VA 23805-2112 |
| Mailing Address |
2002-2004 Wakefield Street Petersburg VA 23805 |
| Practice Telephone | 8047331180 |
| Practice Fax Number | 8047331181 |
| Mailing Telephone | 8047331180 |
| Mailing Fax Number | 8047331181 |
| Enumeration Date | 2010-01-18 |
| Last Update Date | 2013-08-16 |
| Authorized Official Name | MRS. TANIKKA MASON (PROGRAM DIRECTOR) |
| Authorized Official Telephone | 8047331180 |
| Authorized Official Credential | MSW., QMHP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 253Z00000X | In Home Supportive Care | 1389-05-001 | VA | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568860336 | Second Chances Youth Services, LLC | Community/Behavioral Health | 2638 Two Notch Rd, Suite 106, Columbia, SC 29204-1454 | 2014-12-10 |
| Street Address |
2002 WAKEFIELD AVE |
| City | PETERSBURG |
| State | VA |
| Zip Code | 23805-2112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164526760 | Chitra Pidaparti | Psychologist | 2002 Wakefield Ave, Petersburg, VA 23805-2112 | 2006-09-12 |
| 1285182246 | Tanikka Mason | Community/Behavioral Health | 2002 Wakefield Ave, Petersburg, VA 23805-2112 | 2016-09-19 |
| 1659731131 | Tanikka Mason | Social Worker | 2002 Wakefield Ave, Petersburg, VA 23805-2112 | 2016-02-26 |
| 1326420571 | Second Chances Youth Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2002 Wakefield Ave, Petersburg, VA 23805-2112 | 2015-06-24 |
| 1174957591 | Second Chances Youth Services | Community/Behavioral Health | 2002 Wakefield Ave, Petersburg, VA 23805-2112 | 2013-08-22 |
| 1306933932 | Virginia Svidro Nelson | Pediatrics | 2002 Wakefield Ave, Petersburg, VA 23805-2112 | 2006-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134690647 | Miles Viant | Occupational Therapist | 287 E Blvd, Petersburg, VA 23805 | 2018-12-10 |
| 1245756964 | Dexter Shabazz Lett | Registered Nurse | 10543 S. Crater Rd, S. Prince George, VA 23805 | 2017-08-15 |
| 1891145876 | Taylor Enhanced Living | Counselor | 105 Holly Hill Dive, Suite A, Petersburg, VA 23805 | 2016-06-21 |
| 1700255205 | Ina Thompson | Counselor | 272 Medical Park Boulevard, Petersburg, VA 23805 | 2015-09-15 |
| 1932582541 | Valeria Edda Madrid Malo Bohorquez | Internal Medicine | 50 Medical Park Blvd Ste C, Petersburg, VA 23805 | 2015-06-30 |
| 1548642788 | Justin Andrew Phillingane | Podiatrist | 3335 S Crater Rd Ste 500, Petersburg, VA 23805 | 2015-06-24 |
| 1225417082 | Paladin Dermatology LLC | Nurse Practitioner | 44 A& B Medical Park Blvd, Petersburg, VA 23805 | 2015-05-27 |
| 1245652544 | Family Services Inc. | Health Maintenance Organization | 1045 Gustavo Lane, Petersburg, VA 23805 | 2014-01-06 |
| 1619268075 | Charlene Belangia | Massage Therapist | 3323 S. Crater Rd, Suite B, Petersburg, VA 23805 | 2011-04-20 |
| 1760709638 | Caresouth Hha Holdings of Virginia, LLC | Home Health | 34 Medical Park Boulevard, Suite G-h, Petersburg, VA 23805 | 2010-04-30 |
| Find all providers in zip 23805 | ||||
| Taxonomy Code | 253Z00000X |
| Grouping | Agencies |
| Classification | In Home Supportive Care |
| An In Home Supportive Care Agency provides services in the patient’s home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396346227 | Coach for Seniors Inc. | In Home Supportive Care | 7020 Petunia St, Springfield, VA 22152-3448 | 2020-11-06 |
| 1174122162 | Jotava | In Home Supportive Care | 1607 Titanium Avenue, 202, Midlothian, VA 23114 | 2020-10-20 |
| 1629675954 | Uprising Healthcare Services LLC | In Home Supportive Care | 93 Algrace Blvd, Stafford, VA 22556-8608 | 2020-10-09 |
| 1356958136 | Laugh & Live, LLC | In Home Supportive Care | 1702 Todds Lane, Suite 215, Hampton, VA 23666-3213 | 2020-09-25 |
| 1437765716 | Healing Hands Home Health, LLC | In Home Supportive Care | 16520 Goodes Bridge Rd, Amelia Court House, VA 23002-4822 | 2020-09-22 |
| 1861005639 | Icare Home Health Va LLC | In Home Supportive Care | 208 N 2nd Ave Ste 5, Hopewell, VA 23860-2703 | 2020-08-31 |
| 1518570860 | Prime Care Consultants LLC | In Home Supportive Care | 3707 Virginia Beach Blvd Ste 202, Virginia Beach, VA 23452-3412 | 2020-08-26 |
| 1861004491 | Independent Living Home Care L. L.c. | In Home Supportive Care | 6115 Mantle Rd, Burke, VA 22015-3807 | 2020-08-17 |
| 1407466931 | Francine Rose Williams | In Home Supportive Care | 17140 Shands Rd, South Prince George, VA 23805-8537 | 2020-08-10 |
| 1255940896 | Elderlescent Care Incorporated | In Home Supportive Care | 3520 Skipping Rock Way, Richmond, VA 23234-2971 | 2020-07-29 |
| Find all providers with the same taxonomy | ||||
| City | PETERSBURG |
| Zip Code | 23805 |
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| 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.