Second Chance Outreach Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SECOND CHANCE OUTREACH SERVICES

Practice address

1607 E Dixon Blvd
Shelby, NC 28152-6976

Phone

(704) 300-2226

NPI assigned

Sep 21, 2012

Last updated

Sep 22, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jerry Beam

Title

Owner

Phone

(704) 300-2226

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1348185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348272000000",
    "number": "1427309103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 E DIXON BLVD",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281526976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 E DIXON BLVD",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281526976",
            "telephone_number": "704-300-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND CHANCE OUTREACH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-21",
        "last_updated": "2012-09-22",
        "status": "A",
        "authorized_official_last_name": "BEAM",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-300-2226"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erik L Schuls, MD
• Collette Scruggs
• Lydia Perrin Scruggs, LCSW
• Lynn Etters Scruggs, RPH
• Emily Sealey, PTA
• Second Chance Recovery Center Inc.
• Nelson Seen, MD
• Edwin Seh Achu, MD
• Self Determination, LLC
• Senior Total Life Care

• Community/Behavioral Health Agency in Shelby, NC
• Providers in Shelby, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2012; 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.