Provider Demographics
NPI:1134654791
Name:ONE MORE CHANCEE
Entity Type:Organization
Organization Name:ONE MORE CHANCEE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR AND FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ARSENIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-271-3054
Mailing Address - Street 1:PO BOX 1455
Mailing Address - Street 2:
Mailing Address - City:OLIVEHURST
Mailing Address - State:CA
Mailing Address - Zip Code:95961-1455
Mailing Address - Country:US
Mailing Address - Phone:916-271-3054
Mailing Address - Fax:530-870-8971
Practice Address - Street 1:5451 LEMON HILL AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95824-1529
Practice Address - Country:US
Practice Address - Phone:916-433-2600
Practice Address - Fax:916-433-2640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12933251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health