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General NPI Number Information
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NPI Number | 1134654791
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Entity Type | Organization
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Legal Business Name | ONE MORE CHANCEE
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Dates
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Enumeration Date | 04/20/2017
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Last Update Date | 04/20/2017
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Provider Practice Location Address
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Address Line | 5451 LEMON HILL AVE
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City | SACRAMENTO
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State | CA
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Zip | 95824-1529
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Country | US
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Telephone | 916-433-2600
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Fax | 916-433-2640
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Provider Business Mailing Address
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Address Line | PO BOX 1455
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City | OLIVEHURST
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State | CA
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Zip | 95961-1455
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Country | US
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Telephone | 916-271-3054
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Fax | 530-870-8971
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Authorized Official
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Title or Position | DIRECTOR AND FOUNDER
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Name | ARSENIA ANN HARRISON
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Credential |
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Telephone | 916-271-3054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 12933
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License Number State | CA
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