Healthcare Provider Details

I. General information

NPI: 1952248676
Provider Name (Legal Business Name): SECOND CHANCE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7826 EASTERN AVE NE, WASHINGTON D.C 20012 201
WASHINGTON DC
20012
US

IV. Provider business mailing address

7826 EASTERN AVE NE, WASHINGTON D.C 20012 201
WASHINGTON DC
20012
US

V. Phone/Fax

Practice location:
  • Phone: 202-743-3024
  • Fax:
Mailing address:
  • Phone: 202-743-3024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ALICE N ASONGANYI
Title or Position: CO-OWNER
Credential:
Phone: 202-743-3024