Provider Demographics
NPI:1538648431
Name:A SECOND CHANCE RESOURCE CENTER NETWORK UNITED, INCORPORATED
Entity Type:Organization
Organization Name:A SECOND CHANCE RESOURCE CENTER NETWORK UNITED, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATSY
Authorized Official - Middle Name:H
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CAAP
Authorized Official - Phone:843-552-1928
Mailing Address - Street 1:7916 ELDERBERRY CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29418-2133
Mailing Address - Country:US
Mailing Address - Phone:843-552-1928
Mailing Address - Fax:844-836-2383
Practice Address - Street 1:3236 LANDMARK DR STE 100
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29418-8489
Practice Address - Country:US
Practice Address - Phone:843-552-1928
Practice Address - Fax:844-836-2383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management