Second Chance at Hand Outreach Center LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SECOND CHANCE AT HAND OUTREACH CENTER LLC

Practice address

1830 S Alma School Rd Ste 134
Mesa, AZ 85210-3088

Phone

(601) 508-6446

NPI assigned

Oct 8, 2021

Organization subpart

No

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

Authorized official

Name

Quantina Riley

Title

Executive Director

Phone

(601) 508-6446

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634169600000",
    "number": "1235891193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 S ALMA SCHOOL RD STE 134",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103088",
            "telephone_number": "601-508-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 S ALMA SCHOOL RD STE 134",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103088",
            "telephone_number": "601-508-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND CHANCE AT HAND OUTREACH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-08",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "QUANTINA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "601-508-6446"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; 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.