Provider Demographics
NPI:1679821227
Name:NEW OPPORTUNITIES SECOND CHANCE, INC.
Entity type:Organization
Organization Name:NEW OPPORTUNITIES SECOND CHANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:BETHENA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CSAC, LCAS-A
Authorized Official - Phone:919-633-8360
Mailing Address - Street 1:PO BOX 802
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27702-0802
Mailing Address - Country:US
Mailing Address - Phone:919-682-4771
Mailing Address - Fax:919-683-2641
Practice Address - Street 1:2604 CARVER ST
Practice Address - Street 2:SUITE C
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2796
Practice Address - Country:US
Practice Address - Phone:919-682-4771
Practice Address - Fax:919-683-2641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health