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NPI Code Detail

MEDICARE: SECOND CHANCE EMPOWERMENT CENTER

MEDICARE: SECOND CHANCE EMPOWERMENT CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1093411795
Entity Type Code : Organization
Provider Name (Legal Business Name) : SECOND CHANCE EMPOWERMENT CENTER
Provider Business Mailing Address
First Line : 3810 TUNDRA SWAN ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89122-3536
Country : US
Telephone Number : 702-741-3784
Fax Number :
Provider Business Practice Location Address
First Line : 3810 TUNDRA SWAN ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89122-3536
Country : US
Telephone Number : 702-741-3784
Fax Number :
Authorized Official
Title or Position : CEO
Name : CARMON SCOTT
Credential :
Telephone Number : 702-741-3784
Provider Enumeration Date : 02/03/2023
Last Update Date : 02/03/2023

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Directions to “SECOND CHANCE EMPOWERMENT CENTER ” Practice Location

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