Provider Demographics
NPI:1255180626
Name:SECOND CHANCE HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:SECOND CHANCE HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-929-1783
Mailing Address - Street 1:752 CEDAR RD STE 104
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-7227
Mailing Address - Country:US
Mailing Address - Phone:443-299-8874
Mailing Address - Fax:
Practice Address - Street 1:752 CEDAR RD STE 104
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-7227
Practice Address - Country:US
Practice Address - Phone:757-929-1783
Practice Address - Fax:757-765-5570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-16
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty