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General NPI Number Information
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NPI Number | 1447194998
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Entity Type | Organization
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Legal Business Name | SECOND CHANCE PEER SUPPORT SERVICES LLC
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Dates
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Enumeration Date | 04/15/2026
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Last Update Date | 04/30/2026
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Provider Practice Location Address
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Address Line | 926 SUNSTONE DR
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City | DURHAM
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State | NC
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Zip | 27712-1500
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Country | US
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Telephone | 919-316-9539
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Fax | 919-316-9539
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Provider Business Mailing Address
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Address Line | 926 SUNSTONE DR
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City | DURHAM
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State | NC
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Zip | 27712-1500
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Country | US
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Telephone | 919-316-9539
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Fax | 919-316-9539
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Authorized Official
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Title or Position | CEO
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Name | RON BULLOCK
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Credential |
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Telephone | 919-316-9539
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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 |
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License Number State |
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