NEW OUTLOOK SECOND CHANCE INC. NPI 1104069905

NPI Information

NPI: 1104069905
Provider Name: NEW OUTLOOK SECOND CHANCE, INC.
Classification: Clinic/Center - 261QR0405X
Specialization: Rehabilitation, Substance Use Disorder
Entity Type: Organization
Address: 331 W MAIN ST
SUITE 302-306
DURHAM, NC
ZIP 27701
Phone: (919) 682-4771

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NPI Details

NEW OUTLOOK SECOND CHANCE, INC. is a rehabilitation and substance use disorder clinic center in Durham, NC. NEW OUTLOOK SECOND CHANCE, INC. NPI is 1104069905. The provider is registered as an organization entity type.

The provider's business location address is:

331 W MAIN ST
SUITE 302-306
DURHAM, NC
ZIP 27701-232
Phone: (919) 682-4771
Fax: (919) 683-2641

The provider's authorized official is Bethena M Jackson .
The authorized official title is Executive Director and has the following contact phone number (919) 682-4771.

The enumeration date for this NPI number is 4/9/2009 and was last updated on 4/9/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	8302362G	MEDICAID	NORTH CAROLINA
2	8302362B	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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