| Second Chance Living Supportive Services | |
|
3031 W Grand Blvd Ste 522 Detroit MI 48202-3187 | |
| (248) 313-4775 | |
| (313) 566-9229 |
| Full Name | Second Chance Living Supportive Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3031 W Grand Blvd Ste 522, Detroit, Michigan |
| Authorized Official Name and Position | Darren Kilgore (EXECUTIVE DORECTOR) |
| Authorized Official Contact | 2483134775 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Second Chance Living Supportive Services 269 Walker St Suite 538 Detroit MI 48207-4258 Ph: (313) 610-0134 | Second Chance Living Supportive Services 3031 W Grand Blvd Ste 522 Detroit MI 48202-3187 Ph: (248) 313-4775 |
| NPI Number | 1710398045 |
|---|---|
| Provider Enumeration Date | 05/08/2014 |
| Last Update Date | 05/03/2024 |
| Certification Date | 05/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710398045 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 253Z00000X | In Home Supportive Care | (* (Not Available)) | Secondary |
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