Home of Second Chances, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

HOME OF SECOND CHANCES, LLC

Practice address

2216 W Meadowview Rd Ste 105
Greensboro, NC 27407-3401

Phone

(336) 285-9031

Fax

(336) 285-9032

NPI assigned

Mar 5, 2010

Last updated

Mar 5, 2010By 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

Mrs. Cynthia K Jones

Title

Owner/Member

Phone

(336) 285-9031

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Home of Second Chances LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Home of Second Chances,LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Greensboro, NC
  • NPI 1144457813
  NPD tax ID
• Homeofsecondchances,LLC

  • Community/Behavioral Health Agency
  • Greensboro, NC
  • NPI 1669776779
  NPD tax ID

Locations

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

{
    "created_epoch": "1267747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267747200000",
    "number": "1851614762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2216 W MEADOWVIEW RD STE 105",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274073401",
            "telephone_number": "336-285-9031",
            "fax_number": "336-285-9032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2216 W MEADOWVIEW RD STE 105",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274073401",
            "telephone_number": "336-285-9031",
            "fax_number": "336-285-9032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME OF SECOND CHANCES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-05",
        "last_updated": "2010-03-05",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "336-285-9031",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302865B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8302865H",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ariel Holtzman, CRNA
• Scott Holwerda, M.D.
• Barry Gray Holyfield
• Home of Second Chances
• Home of Second Chances
• Home of Second Chances,LLC
• Home Strong Therapy LLC
• Homeofsecondchances,LLC
• Deanna Marie Homer, PHARM.D.
• Homes That Care, Inc.

• Community/Behavioral Health Agency in Greensboro, NC
• Providers in Greensboro, 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 Mar 5, 2010; 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.