| Second Chance Youth Community Center Inc | |
|
3303 Salem Rd Covington GA 30016-1865 | |
| (978) 219-3577 | |
| (770) 267-3248 |
| Full Name | Second Chance Youth Community Center Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3303 Salem Rd, Covington, Georgia |
| Authorized Official Name and Position | Mirline Lozispolynice (CEO) |
| Authorized Official Contact | 6784689295 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Second Chance Youth Community Center Inc 2899 H D Atha Rd Covington GA 30014-0728 Ph: (678) 468-9295 | Second Chance Youth Community Center Inc 3303 Salem Rd Covington GA 30016-1865 Ph: (978) 219-3577 |
| NPI Number | 1023444197 |
|---|---|
| Provider Enumeration Date | 09/20/2013 |
| Last Update Date | 09/20/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023444197 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 07088392 (Georgia) | Primary |
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