Provider Demographics
NPI:1770930182
Name:SECOND CHANCES INC
Entity type:Organization
Organization Name:SECOND CHANCES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SROUFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-439-7785
Mailing Address - Street 1:381 WICKENDEN ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4425
Mailing Address - Country:US
Mailing Address - Phone:877-557-3155
Mailing Address - Fax:
Practice Address - Street 1:381 WICKENDEN ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4425
Practice Address - Country:US
Practice Address - Phone:877-557-3155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-17
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty