Provider Demographics
NPI:1558693150
Name:SECOND CHANCES HOME CARE
Entity Type:Organization
Organization Name:SECOND CHANCES HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-756-1244
Mailing Address - Street 1:3005 S MEMORIAL DR STE C
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-6224
Mailing Address - Country:US
Mailing Address - Phone:252-756-1244
Mailing Address - Fax:252-756-1244
Practice Address - Street 1:3005 S MEMORIAL DR STE C
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-6224
Practice Address - Country:US
Practice Address - Phone:252-756-1244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-05
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4023251B00000X
251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No253Z00000XAgenciesIn Home Supportive Care