Second Chance for You

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

0601002 Issued in NC

Legal business name

SECOND CHANCE FOR YOU

Doing business as

Second Chance 4 Kidz

Practice address

1526 Peachcroft Rd
Charlotte, NC 28216-2747

Phone

(704) 231-2889

NPI assigned

Aug 29, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Kertrenia S Jones

Title

Owner

Phone

(704) 807-5910

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Second Chance 4 Kidz Doing business as

Tax ID family

Second Chance 4 Kidz2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Second Chance for You

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Charlotte, NC
  • NPI 1104995182
  NPD tax ID

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188345600000",
    "number": "1083808497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 SOUTHWIND DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282168846",
            "telephone_number": "704-231-2889",
            "fax_number": "704-971-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 PEACHCROFT RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282162747",
            "telephone_number": "704-231-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND CHANCE FOR YOU",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-08-29",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "KERTRENIA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-807-5910",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "0601002",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "0601002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7805669",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Second Chance 4 Kidz",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Neethu Sebastian, DMD
• Sonia Lau Sebastiano, P.A.-C
• Amanda Marie Sebring, MD
• Joseph W Sechler, MD
• Second 2 None Educational Services (Helping Others Health Care Services)
• Second Chance for You
• Second Chance Group Homes LLC
• Second Chance Services
• Second Chances Peer Support LLC
• Secong Chance Transitional Living Inc

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; 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.