2ND Chance Behavioral Health Services LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

2ND CHANCE BEHAVIORAL HEALTH SERVICES LLC

Practice address

10620 N 43Rd Ave Ste 10
Glendale, AZ 85304-4150

Phone

(602) 860-0044

Fax

(602) 848-3186

NPI assigned

Apr 21, 2023

Last updated

Apr 21, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Domity Akoi, CEO

Title

Administrator

Phone

(602) 860-0044

Specialties & licenses 6

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Peter Njogu

  • Psychiatric/Mental Health Nurse Practitioner
  • San Tan Valley, AZ
  • NPI 1437862257
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682035200000",
    "number": "1053008870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10620 N 43RD AVE STE 10",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853044150",
            "telephone_number": "602-860-0044",
            "fax_number": "602-848-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10620 N 43RD AVE STE 10",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853044150",
            "telephone_number": "602-860-0044",
            "fax_number": "602-848-3186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "2ND CHANCE BEHAVIORAL HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-21",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-19",
        "status": "A",
        "authorized_official_last_name": "AKOI",
        "authorized_official_first_name": "DOMITY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "602-860-0044",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Theranest",
            "affiliation": "N",
            "endpointDescription": "EHR system",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10620 N 43rd Ave",
            "address_2": "Suite 10",
            "city": "Glendale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "85304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Adult Mental Health Clinic/Center in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Adult Mental Health Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.