NPIMap

Organization Active NPI

Second Chance Res Adult Services

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Greensboro, NC
National Provider Identifier
1427239979
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
MHL041816 Issued in NC
Legal business name
SECOND CHANCE RES ADULT SERVICES
Practice address
907 Dillard St
Greensboro, NC 27403-3022
Phone
(336) 230-1676
Fax
(336) 294-7657
NPI assigned
Nov 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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

Authorized official

Name
Ms. Ravonda C Meachem, MS ADULT EDUCATIONNPI 1699971838
Title
Director Owner
Phone
(336) 707-6517

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X MHL041816 NC Primary

Addresses

Primary practice location

907 Dillard St
Greensboro, NC 27403-3022

Mailing address

907 Dillard St
Greensboro, NC 27403-3022
Phone (336) 230-1676

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1427239979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 DILLARD ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274033022",
            "telephone_number": "336-230-1676",
            "fax_number": "336-230-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 DILLARD ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274033022",
            "telephone_number": "336-230-1676",
            "fax_number": "336-294-7657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND CHANCE RES ADULT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-26",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "MEACHEM",
        "authorized_official_first_name": "RAVONDA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR OWNER",
        "authorized_official_telephone_number": "336-707-6517",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS ADULT EDUCATION"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL041816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; 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.