Provider Demographics
NPI:1649562976
Name:ANOTHER CHANCE ENTERPRISE, INC.
Entity Type:Organization
Organization Name:ANOTHER CHANCE ENTERPRISE, INC.
Other - Org Name:ANOTHER CHANCE ENTERPRISE ADULT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:CLAY
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:318-325-9503
Mailing Address - Street 1:3001 ARMAND ST STE D&E
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-3754
Mailing Address - Country:US
Mailing Address - Phone:318-325-9503
Mailing Address - Fax:
Practice Address - Street 1:111 MAIN STREET
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:LA
Practice Address - Zip Code:71418
Practice Address - Country:US
Practice Address - Phone:318-649-2855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1326282856Medicaid
LA1245448992Medicaid
LA1184863380Medicaid
LA1083821417Medicaid
LA1669690962Medicaid
LA1548498629Medicaid