SECOND CHANCES YOUTH SERVICES (NPI# 1003196379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003196379 |
| Entity Type | Organization |
| Organization Name | SECOND CHANCES YOUTH SERVICES |
| Practice Address |
139b Baker St Emporia VA 23847-1703 |
| Mailing Address |
20 E Tabb St Suite 100 Petersburg VA 23803-4541 |
| Practice Telephone | 4343361010 |
| Practice Fax Number | 4343361110 |
| Mailing Telephone | 8047331180 |
| Mailing Fax Number | 8047331181 |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2011-08-18 |
| Authorized Official Name | MR. DAMION RICARDO MASON (CEO) |
| Authorized Official Telephone | 8047331180 |
| Authorized Official Credential | B.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 1389 | VA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1245530500 | 05 | |
| VA | 1831420660 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154978674 | Second Chances Youth Services | Community/Behavioral Health | 5801 Allentown Rd Ste 308, Camp Springs, MD 20746-4566 | 2019-08-20 |
| 1427505379 | Second Chances Youth Services | Community/Behavioral Health | 207 Business Park Dr, Suite 201, Va Beach, VA 23462-6536 | 2016-09-08 |
| 1154861631 | Second Chances Youth Services | Community/Behavioral Health | 527 N Main St, Emporia, VA 23847-1235 | 2017-03-02 |
| 1326420571 | Second Chances Youth Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2002 Wakefield Ave, Petersburg, VA 23805-2112 | 2015-06-24 |
| 1174957591 | Second Chances Youth Services | Community/Behavioral Health | 2002 Wakefield Ave, Petersburg, VA 23805-2112 | 2013-08-22 |
| 1760755383 | Second Chances Youth Services | Community/Behavioral Health | 601 N Mechanic St, Suite 414, Franklin, VA 23851-1455 | 2012-02-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Second Chances Youth Services L.L.C. | 320 E. Broadway, Hopewell, Virginia 23860 |
| Street Address |
139B BAKER ST |
| City | EMPORIA |
| State | VA |
| Zip Code | 23847-1703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831689454 | Laniesha Stephens Dunn | Social Worker | 407 Halifax St Ste 3, Emporia, VA 23847 | 2018-05-18 |
| 1073016382 | Audrey O Brown | Private Vehicle | 2926 Slagles Road, Emporia, VA 23847 | 2018-03-13 |
| 1598280844 | Daisy's Transportation LLC | Driver | 710 N. Main Street, Emporia, VA 23847 | 2017-08-08 |
| 1336486836 | From Start 2 Finish Counseling Services, Inc | Community/Behavioral Health | 425d South Main Street, Emporia, VA 23847 | 2013-01-03 |
| 1316245681 | William Robert Shannonhouse Jr. | Pharmacist | 220 Market Drive, Emporia, VA 23847 | 2011-03-10 |
| 1669791984 | District 19 Community Services Board | Nursing Care | 502 Sadler Dr, Emporia, VA 23847 | 2010-05-26 |
| 1740310143 | Harold J Neal, Jr. Dds, PC | Dentist | 508 Belfield Dr., Emporia, VA 23847 | 2007-03-06 |
| 1376637504 | Charles V Omick | Nurse Anesthetist, Certified Registered | 727 North Main Street, Emporia, VA 23847 | 2006-10-03 |
| 1669496030 | Prince Squire Medical Center PC | Family Medicine | 219 Weaver Avenue, Emporia, VA 23847 | 2006-07-27 |
| 1003838442 | Marcelin Medical Center | Clinic/Center | 137 Baker Sreet, Emporia, VA 23847 | 2006-07-24 |
| Find all providers in zip 23847 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912406554 | Elite Family Counseling Services | Community/Behavioral Health | 401 Halifax St Ste 2a, Emporia, VA 23847-1711 | 2018-02-09 |
| 1437673613 | The Trio Consulting Group | Community/Behavioral Health | 90 Otterdam Rd, Emporia, VA 23847-6400 | 2017-07-31 |
| 1497202980 | S.t.a.a.n.d Youth Services, LLC | Community/Behavioral Health | 1510 Belmeadow Cir, Emporia, VA 23847-2702 | 2016-09-01 |
| 1336486836 | From Start 2 Finish Counseling Services, Inc | Community/Behavioral Health | 425d South Main Street, Emporia, VA 23847 | 2013-01-03 |
| 1093077315 | New Journey Family Services, LLC | Community/Behavioral Health | 156a Baker St, Emporia, VA 23847-1720 | 2012-06-12 |
| 1952676330 | Hope First LLC | Community/Behavioral Health | 215 Weaver Ave, Emporia, VA 23847-1248 | 2012-03-19 |
| 1538396544 | Path To Recovery | Community/Behavioral Health | 1420 C of E Dr Ste 300, Emporia, KS 66801-2585 | 2009-06-17 |
| 1811146855 | Holistic Therapy | Community/Behavioral Health | 1101 Commercial St, Emporia, KS 66801-2989 | 2008-09-15 |
| 1154477933 | Mental Health Center of East Central Kansas | Community/Behavioral Health | 104 E 8th Ave, Emporia, KS 66801-2929 | 2007-01-26 |
| 1154861631 | Second Chances Youth Services | Community/Behavioral Health | 527 N Main St, Emporia, VA 23847-1235 | 2017-03-02 |
| Find all providers in EMPORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.