NPIMap

Organization Active NPI

Second Chance Addiction Care LLC

  • Substance Abuse Rehabilitation Facility
  • Rockville, MD
National Provider Identifier
1629835236
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
SECOND CHANCE ADDICTION CARE LLC
Practice address
401 E Jefferson St Ste 203
Rockville, MD 20850-2617
Phone
(301) 983-5130
Fax
(855) 270-6701
NPI assigned
Feb 29, 2024
Organization subpart
Yes
Parent organization
SECOND CHANCE ADDICTION CARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Authorized official

Name
Jessie Costley
Title
Credentialing Manager
Phone
(443) 839-6928

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

401 E Jefferson St Ste 203
Rockville, MD 20850-2617

Mailing address

9800 Falls Rd Ste 7
Potomac, MD 20854-3942
Phone (301) 983-5130

National Provider Directory

National Provider Directory
Tax ID family
Second Chance Addiction Care4 organizations share this tax ID, including this one
Part of
Second Chance Addiction Care

Other organizations with this tax ID 3

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": "1709164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1629835236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9800 FALLS RD STE 7",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208543942",
            "telephone_number": "301-983-5130",
            "fax_number": "855-270-6701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E JEFFERSON ST STE 203",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208502617",
            "telephone_number": "301-983-5130",
            "fax_number": "855-270-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND CHANCE ADDICTION CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SECOND CHANCE ADDICTION CARE LLC",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "COSTLEY",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "443-839-6928"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.