Second Chance Recovery Incorporated

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

SECOND CHANCE RECOVERY INCORPORATED

Practice address

11104 West Airport Blvd. Suite 214
Stafford, TX 77477

Phone

(281) 835-4230

Fax

(315) 628-1119

NPI assigned

Aug 10, 2016

Organization subpart

No

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

Authorized official

Name

Theresa Bannis

Title

Ceo

Phone

(832) 869-8856

Specialties & licenses 2

Addresses

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.

• Ezzard Charles Williams, LCDC

  • Addiction (Substance Use Disorder) Counselor
  • Houston, TX
  • NPI 1811407760
  NPD (past)

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

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628553600000",
    "number": "1245784016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11104 WEST AIRPORT BLVD. SUITE 214",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "77477",
            "telephone_number": "281-835-4230",
            "fax_number": "315-628-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11104 WEST AIRPORT BLVD. SUITE 214",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "77477",
            "telephone_number": "281-835-4230",
            "fax_number": "315-628-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND CHANCE RECOVERY INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-10",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A",
        "authorized_official_last_name": "BANNIS",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "832-869-8856"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "TX",
            "license": "40824083",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Jill Schlattmann, LVN
• Deandra Schmersahl, LVN
• Maria S Scott, LVN
• Shawnon Battieste Scott, LVN
• Scruggs & Associates Family Counseling Center, P.C., Inc.
• Second Mile Mission Center
• Select Health Care Inc
• Nikki Selke
• Serene Retreat Spa & Wellness LLC (Serene Retreat Spa)
• Serenity Healthcare Services Inc

• Substance Use Disorder Rehabilitation Clinic/Center in Stafford, TX
• Providers in Stafford, TX by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.