Second Chance Homes

Primary specialty

ContractorTaxonomy code 171W00000X

License

71608N Issued in MI

Legal business name

SECOND CHANCE HOMES

Doing business as

Mary Katherines Charities

Practice address

17300 Schaefer Hwy # a-2
Detroit, MI 48235-4133

Phone

(586) 339-6101

NPI assigned

May 12, 2015

Last updated

May 12, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

MARY KATHERINES CHARITIESAs reported in NPPES

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

Authorized official

Name

Mr. Okezie Wachuku

Title

Executive Director

Phone

(586) 339-6101

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MARY KATHERINES CHARITIES Doing business as

Part of

Second Chance Homes

Locations

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431388800000",
    "number": "1750769683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17300 SCHAEFER HWY # A-2",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482354133",
            "telephone_number": "586-339-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17300 SCHAEFER HWY # A-2",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482354133",
            "telephone_number": "586-339-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND CHANCE HOMES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARY KATHERINES CHARITIES",
        "enumeration_date": "2015-05-12",
        "last_updated": "2015-05-12",
        "status": "A",
        "authorized_official_last_name": "WACHUKU",
        "authorized_official_first_name": "OKEZIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "586-339-6101",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Contractor",
            "state": "MI",
            "license": "71608N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN",
            "identifier": "71608N",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARY KATHERINES CHARITIES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madeline Jane Sebastian, MD
• Sreya Sebastian, MD
• Julie Sebest, CRNA
• Fana Gebrehiwet Sebhatu
• Nabilah A Seblini
• Second Chance Living Supportive Services (SCL Supportive Services)
• Elizabeth Ann Secord, MD
• Camis Lynne Secrest, CHW
• Lawrence Sedano, PA-C
• Kayla Ann Seedial, M.D.

• Contractor in Detroit, MI
• Providers in Detroit, MI by specialty
• Contractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; 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.