MEDICARE: SECOND CHANCE HOME HEALTHCARE

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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1376870907
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SECOND CHANCE HOME HEALTHCARE

Provider Business Mailing Address
First Line	:	7520 COFFEE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77033-3552
Country	:	US
Telephone Number	:	832-881-7567
Fax Number	:	713-731-8354

Provider Business Practice Location Address
First Line	:	7520 COFFEE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77033-3552
Country	:	US
Telephone Number	:	832-881-7567
Fax Number	:	713-731-8354

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. SANDRA KAY DANIELS
Credential	:	LICENSE HOLDER
Telephone Number	:	832-881-7567

Provider Enumeration Date	:	11/03/2009
Last Update Date	:	11/03/2009

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Directions to “SECOND CHANCE HOME HEALTHCARE ” Practice Location

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