Healthcare Provider Details

I. General information

NPI: 1346747029
Provider Name (Legal Business Name): SECOND CHANCE RECOVERY HOUSE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2018
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 CRAIN HWY N STE 5B
GLEN BURNIE MD
21061-9304
US

IV. Provider business mailing address

1410 CRAIN HWY N STE 5B
GLEN BURNIE MD
21061-9304
US

V. Phone/Fax

Practice location:
  • Phone: 410-903-8710
  • Fax:
Mailing address:
  • Phone: 410-267-2844
  • Fax: 866-450-9832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: LITRA SIMMS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 410-267-2844