Provider Demographics
NPI:1790301893
Name:SECOND CHANCE RECOVERY CENTER, INC.
Entity Type:Organization
Organization Name:SECOND CHANCE RECOVERY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HARLO
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:RINGLING
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:918-284-9201
Mailing Address - Street 1:4238 NE 1ST ST
Mailing Address - Street 2:
Mailing Address - City:PRYOR
Mailing Address - State:OK
Mailing Address - Zip Code:74361-9614
Mailing Address - Country:US
Mailing Address - Phone:918-825-1930
Mailing Address - Fax:918-825-1931
Practice Address - Street 1:4238 NE 1ST ST
Practice Address - Street 2:
Practice Address - City:PRYOR
Practice Address - State:OK
Practice Address - Zip Code:74361-9614
Practice Address - Country:US
Practice Address - Phone:918-825-1930
Practice Address - Fax:918-825-1931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility