| NPI | 1619440898 |
|---|---|
| Former Legal Business Name | SECOND CHANCE SUPPORT SERVICES |
| Entity Type | Organization |
| Authorized Contact | MOLUA SMITH BECKE Administrative Director 907-334-1029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2019-01-10 |
| Last Update Date | 2019-01-10 |