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General NPI Number Information
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NPI Number | 1750258471
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Entity Type | Organization
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Legal Business Name | 2ND CHANCE BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 10/17/2025
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 1701 TROOST AVE # 1060
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City | KANSAS CITY
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State | MO
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Zip | 64108-1540
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Country | US
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Telephone | 816-744-5657
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Fax |
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Provider Business Mailing Address
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Address Line | 117 S LEXINGTON ST STE 100
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City | HARRISONVILLE
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State | MO
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Zip | 64701-2444
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Country | US
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Telephone | 816-744-5657
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | CHARLES ANDERSON
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Credential |
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Telephone | 816-744-5657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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