MEDICARE: NEW CHANCE CARE

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
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
2	207QA0401X	Addiction Medicine (Family Medicine) Physician

General Provider Information

NPI Number	:	1952272775
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW CHANCE CARE

Provider Business Mailing Address
First Line	:	7 BROWN AVE
Second Line	:
City	:	SYLACAUGA
State	:	AL
Zip	:	35150-2421
Country	:	US
Telephone Number	:	256-879-8190
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 BROWN AVE
Second Line	:
City	:	SYLACAUGA
State	:	AL
Zip	:	35150-2421
Country	:	US
Telephone Number	:	256-879-8190
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	CHARLES BRENTNALL
Credential	:	MD
Telephone Number	:	205-834-3913

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	09/15/2025

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Directions to “NEW CHANCE CARE ” Practice Location

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