Second Chances CM, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

SECOND CHANCES CM, LLC

Practice address

16687 Saint Clair Ave
Suite 202
East Liverpool, OH 43920-9401

Phone

(330) 398-1076

NPI assigned

Dec 28, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Michael Marantis

Title

Owner

Phone

(330) 502-8051

Specialties & licenses 5

Addresses

Other names 1

• Second Chances Doing business as

Locations

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

{
    "created_epoch": "1451260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466985600000",
    "number": "1669837175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16687 SAINT CLAIR AVE",
            "address_2": "SUITE 202",
            "city": "EAST LIVERPOOL",
            "state": "OH",
            "postal_code": "439209401",
            "telephone_number": "330-398-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16687 SAINT CLAIR AVE",
            "address_2": "SUITE 202",
            "city": "EAST LIVERPOOL",
            "state": "OH",
            "postal_code": "439209401",
            "telephone_number": "330-398-1076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND CHANCES CM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-28",
        "last_updated": "2016-06-27",
        "status": "A",
        "authorized_official_last_name": "MARANTIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-502-8051",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Second Chances",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Physician in East Liverpool, OH
• Providers in East Liverpool, OH by specialty
• General Practice Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; 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.