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General NPI Number Information
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NPI Number | 1851973879
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Entity Type | Organization
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Legal Business Name | ANOTHER CHANCE ENTERPRISE SUPPORT SERVICES INC
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Dates
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Enumeration Date | 04/28/2021
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Last Update Date | 04/28/2021
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Provider Practice Location Address
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Address Line | 2901 EVANGELINE ST
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City | MONROE
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State | LA
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Zip | 71201-3723
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Country | US
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Telephone | 318-267-2674
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Fax | 318-582-5166
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Provider Business Mailing Address
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Address Line | 2901 EVANGELINE ST
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City | MONROE
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State | LA
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Zip | 71201-3723
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Country | US
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Telephone | 318-267-2674
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Fax |
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Authorized Official
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Title or Position | ADMINISTER DIRECTOR
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Name | SIDNEY MOSS
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Credential |
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Telephone | 318-267-2674
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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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