Healthcare Provider Details

I. General information

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

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11016 MERIDIAN HILL WAY
UPPER MARLBORO MD
20772-4073
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: 202-378-6319
  • 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