| Second Chance Family Services Llc | |
|
2480 S Main St # 2062480s South Salt Lake UT 84115-3058 | |
| (702) 510-2817 | |
| (801) 951-0555 |
| Full Name | Second Chance Family Services Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2480 S Main St # 2062480s, South Salt Lake, Utah |
| Authorized Official Name and Position | Jalon Hankston (OWNER) |
| Authorized Official Contact | 7025102817 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Second Chance Family Services Llc 2480 S Main St # 2062480s South Salt Lake UT 84115-3058 Ph: (702) 510-2817 | Second Chance Family Services Llc 2480 S Main St # 2062480s South Salt Lake UT 84115-3058 Ph: (702) 510-2817 |
| NPI Number | 1356129084 |
|---|---|
| Provider Enumeration Date | 09/14/2023 |
| Last Update Date | 09/14/2023 |
| Certification Date | 09/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356129084 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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