SECOND CHANCE BEHAVIORAL HEALTH CENTER LLC (NPI# 1275022170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275022170 |
| Entity Type | Organization |
| Organization Name | SECOND CHANCE BEHAVIORAL HEALTH CENTER LLC |
| Practice Address |
2502 Maryland Ave Baltimore MD 21218-4510 |
| Mailing Address |
10045 Ardenne Way Owings Mills MD 21117-4072 |
| Practice Telephone | 4105049048 |
| Mailing Telephone | 4105049048 |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2018-05-07 |
| Authorized Official Name | TOWANDA TAYLOR (CEO) |
| Authorized Official Telephone | 4105049048 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0401X |
Clinic/Center Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609490838 | Second Chance Behavioral Health Center LLC | Psychiatric Hospital | 5517 Ritchie Hwy, Brooklyn Park, MD 21225-3457 | 2020-06-03 |
| 1275157505 | Second Chance Behavioral Health Center LLC | Clinic/Center | 5517 Ritchie Hwy, Brooklyn Park, MD 21225-3457 | 2020-06-02 |
| 1134610322 | Second Chance Behavioral Health Center LLC | Psychologist | 2502 Maryland Ave, Baltimore, MD 21218-4510 | 2018-05-23 |
| 1134618838 | Second Chance Behavioral Health Center LLC | Clinic/Center | 2502 Maryland Ave, Baltimore, MD 21218-4510 | 2018-05-08 |
| 1093204794 | Second Chance Behavioral Health Center LLC | Substance Abuse Rehabilitation Facility | 2502 Maryland Ave, Baltimore, MD 21218-4510 | 2018-05-08 |
| 1699264317 | Second Chance Behavioral Health Center LLC | Pharmacy | 2502 Maryland Ave, Baltimore, MD 21218-4510 | 2018-05-08 |
| 1992294698 | Second Chance Behavioral Health Center LLC | Clinical Medical Laboratory | 2502 Maryland Ave, Baltimore, MD 21218-4510 | 2018-05-08 |
| 1811486715 | Second Chance Behavioral Health Center LLC | Clinic/Center | 2502 Maryland Ave, Baltimore, MD 21218-4510 | 2018-05-07 |
| 1619495876 | Second Chance Behavioral Health Center LLC | Behavior Technician | 2502 Maryland Ave, Baltimore, MD 21218-4510 | 2017-09-07 |
| Street Address |
2502 MARYLAND AVE |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21218-4510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346454147 | Aisha Dawn Mackall | Social Worker | 2502 Maryland Ave, 1st Floor, Baltimore, MD 21218-4510 | 2007-05-10 |
| 1134610322 | Second Chance Behavioral Health Center LLC | Psychologist | 2502 Maryland Ave, Baltimore, MD 21218-4510 | 2018-05-23 |
| 1134618838 | Second Chance Behavioral Health Center LLC | Clinic/Center | 2502 Maryland Ave, Baltimore, MD 21218-4510 | 2018-05-08 |
| 1093204794 | Second Chance Behavioral Health Center LLC | Substance Abuse Rehabilitation Facility | 2502 Maryland Ave, Baltimore, MD 21218-4510 | 2018-05-08 |
| 1699264317 | Second Chance Behavioral Health Center LLC | Pharmacy | 2502 Maryland Ave, Baltimore, MD 21218-4510 | 2018-05-08 |
| 1992294698 | Second Chance Behavioral Health Center LLC | Clinical Medical Laboratory | 2502 Maryland Ave, Baltimore, MD 21218-4510 | 2018-05-08 |
| 1811486715 | Second Chance Behavioral Health Center LLC | Clinic/Center | 2502 Maryland Ave, Baltimore, MD 21218-4510 | 2018-05-07 |
| 1891298279 | Second Chance Behavioral Health Services | Clinic/Center | 2502 Maryland Ave, Baltimore, MD 21218-4510 | 2018-03-13 |
| 1619495876 | Second Chance Behavioral Health Center LLC | Behavior Technician | 2502 Maryland Ave, Baltimore, MD 21218-4510 | 2017-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851933725 | Tierra Bouyer | Speech-Language Pathologist | 2040 East 32nd Street, Baltimore, MD 21218 | 2019-10-12 |
| 1093273559 | Brenda H. Wells | Social Worker | 200 E. North Ave., Baltimore, MD 21218 | 2019-03-04 |
| 1619441011 | Harwood Behavioral Health Partners, LLC | Community/Behavioral Health | 2514 Greenmount Avenue, Baltimore, MD 21218 | 2019-01-18 |
| 1649740291 | Elise Christine Starkey | Occupational Therapist | 801 Argonne Drive, Baltimore, MD 21218 | 2018-11-27 |
| 1851861421 | Alagra S Bass | Social Worker | 1900 N. Howard Street Suite 300, Baltimore, MD 21218 | 2018-11-27 |
| 1396213575 | Desiree Luerene Israel | Social Worker | 2000 Greenmount Ave Ste 101, Baltimore, MD 21218 | 2018-11-06 |
| 1952885451 | Harwood Behavioral Health Partners, LLC | Clinic/Center | 2514 Greenmount Ave, Baltimore, MD 21218 | 2018-09-20 |
| 1528548047 | Rozi Khan | Student in an Organized Health Care Education/Training Program | 325 East University Pkwy 1-3, Bltimore, MD 21218 | 2018-08-14 |
| 1558866202 | Prabij N/a Dhungana | Student in an Organized Health Care Education/Training Program | 201 E. University Parkway, Dept of Medicine, Baltimore, MD 21218 | 2018-03-26 |
| 1588163562 | Generation 5 Healthcare, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 707 Belgian Ave., Baltimore, MD 21218 | 2018-02-06 |
| Find all providers in zip 21218 | ||||
| Taxonomy Code | 261QR0401X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Definition to come... |
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| 1174077796 | Mosaic Community Services, Inc. | Clinic/Center | 9201 Philadelphia Rd, Baltimore, MD 21237-4318 | 2016-08-11 |
| 1427502046 | Mosaic Community Services, Inc. | Clinic/Center | 9201 Philadelphia Rd, Baltimore, MD 21237-4318 | 2016-08-11 |
| 1588016422 | Mosaic Community Services, Inc. | Clinic/Center | 234 S Broadway, Baltimore, MD 21231-2405 | 2016-07-03 |
| Find all providers in BALTIMORE | ||||
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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.