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NPI Code Detail

MEDICARE: SECOND START INCORPORATED

MEDICARE: SECOND START INCORPORATED
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174200000XMeals Provider
2251E00000XHome Health Agency
3251K00000XPublic Health or Welfare Agency
4251V00000XVoluntary or Charitable Agency
5251X00000XSupports Brokerage Agency
6253Z00000XIn Home Supportive Care Agency
7311Z00000XCustodial Care Facility
8347C00000XPrivate Vehicle
9385H00000XRespite Care
10177F00000XLodging Provider

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1561-255-7777OTHERTELEPHONE NUMBER

General Provider Information

NPI Number : 1750949236
Entity Type Code : Organization
Provider Name (Legal Business Name) : SECOND START INCORPORATED
Provider Business Mailing Address
First Line : 4583 DIEKHANS RD APT 4
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33417-3000
Country : US
Telephone Number : 561-255-7777
Fax Number :
Provider Business Practice Location Address
First Line : 4583 DIEKHANS RD APT 4
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33417-3000
Country : US
Telephone Number : 561-255-7777
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : SANDRA M CAMERON
Credential :
Telephone Number : 561-255-7777
Provider Enumeration Date : 05/30/2019
Last Update Date : 06/11/2019

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Directions to “SECOND START INCORPORATED ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.