Provider Demographics
NPI:1386409894
Name:ANOTHER CHANCE FOR HOPE LLC
Entity type:Organization
Organization Name:ANOTHER CHANCE FOR HOPE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FREDRICKA
Authorized Official - Middle Name:
Authorized Official - Last Name:BREAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-931-8838
Mailing Address - Street 1:2555 CAPITOL DR STE E-2
Mailing Address - Street 2:
Mailing Address - City:CREEDMOOR
Mailing Address - State:NC
Mailing Address - Zip Code:27522-7398
Mailing Address - Country:US
Mailing Address - Phone:757-406-9040
Mailing Address - Fax:
Practice Address - Street 1:2555 CAPITOL DR STE E-2
Practice Address - Street 2:
Practice Address - City:CREEDMOOR
Practice Address - State:NC
Practice Address - Zip Code:27522-7398
Practice Address - Country:US
Practice Address - Phone:919-931-8838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-14
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty