Healthcare Provider Details

I. General information

NPI: 1679492193
Provider Name (Legal Business Name): 2ND CHANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 N BROADWAY
LEXINGTON KY
40505-3155
US

IV. Provider business mailing address

1420 N BROADWAY
LEXINGTON KY
40505-3155
US

V. Phone/Fax

Practice location:
  • Phone: 859-368-8820
  • Fax:
Mailing address:
  • Phone: 859-368-8820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH H FARMER
Title or Position: OFFICE MANAGER
Credential:
Phone: 859-368-8820