Provider Demographics
NPI:1851973879
Name:ANOTHER CHANCE ENTERPRISE SUPPORT SERVICES INC
Entity Type:Organization
Organization Name:ANOTHER CHANCE ENTERPRISE SUPPORT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTER DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-267-2674
Mailing Address - Street 1:2901 EVANGELINE ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-3723
Mailing Address - Country:US
Mailing Address - Phone:318-267-2674
Mailing Address - Fax:
Practice Address - Street 1:2901 EVANGELINE ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-3723
Practice Address - Country:US
Practice Address - Phone:318-267-2674
Practice Address - Fax:318-582-5166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health