NPIMap

Organization Active NPI

Second Chance Behavioral Health Center LLC

  • Rehabilitation Psychologist
  • Baltimore, MD
National Provider Identifier
1134610322
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PsychologistTaxonomy code 103TR0400X
Legal business name
SECOND CHANCE BEHAVIORAL HEALTH CENTER LLC
Practice address
2502 Maryland Ave
Baltimore, MD 21218-4510
Phone
(410) 504-9048
NPI assigned
May 23, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2018

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

Authorized official

Name
Towanda Taylor
Title
Ceo
Phone
(410) 504-9048

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TR0400X Primary

Addresses

Primary practice location

2502 Maryland Ave
Baltimore, MD 21218-4510

Mailing address

10045 Ardenne Way
Owings Mills, MD 21117-4072
Phone (410) 504-9048

National Provider Directory

National Provider Directory
Tax ID family
Second Chance Behavioral Health Center LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527033600000",
    "number": "1134610322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10045 ARDENNE WAY",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174072",
            "telephone_number": "410-504-9048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 MARYLAND AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212184510",
            "telephone_number": "410-504-9048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND CHANCE BEHAVIORAL HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-23",
        "last_updated": "2018-05-23",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "TOWANDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-504-9048"
    },
    "taxonomies": [
        {
            "code": "103TR0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; 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.