Second Chance Home LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

SECOND CHANCE HOME LLC

Practice address

2805 94TH Way
Brooklyn Park, MN 55444-2958

Phone

(952) 454-1157

NPI assigned

Jan 16, 2023

Organization subpart

No

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

Authorized official

Name

Mohamed Yusuf Dawid

Title

Ceo

Phone

(952) 454-1157

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673827200000",
    "number": "1639884620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 94TH WAY",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554442958",
            "telephone_number": "952-454-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 94TH WAY",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554442958",
            "telephone_number": "952-454-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND CHANCE HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-14",
        "status": "A",
        "authorized_official_last_name": "DAWID",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "YUSUF",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "952-454-1157"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "RESTful",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2805 94th Way",
            "city": "Brooklyn Park",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554442958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sawubona Wellness P.C.
• Duane G Schaefer, LADC
• Holly Marie Schlangen Rice, OTR
• Peter A Schlesinger, MD
• Scooter Store - Minneapolis L L C (The SCOOTER Store/Alliance Seating & Mobility)
• Secured Health and Homecare Inc (Secured Health Assisted Living)
• Secured Health and Homecare Inc
• Secured Health and Homecare Inc
• Seeds of Change Community Services LLC (Eeds of Change Community Services LLC)
• Sefertt Health Care LLC

• Case Management Agency in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Case Management Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; 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.