MIRACLES OF A SECOND CHANCE INC NPI 1710740097

NPI Information

NPI: 1710740097
Provider Name: MIRACLES OF A SECOND CHANCE INC

Doing Business As: MIRACLES OF A SECOND CHANCE INC

Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
507 19TH TER
BISBEE, AZ
ZIP 85603
Phone: (520) 255-2158
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MIRACLES OF A SECOND CHANCE INC is a substance abuse rehabilitation facility in Bisbee, AZ. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. MIRACLES OF A SECOND CHANCE INC NPI is 1710740097. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Miracles Of A Second Chance Inc.

The provider's business location address is:

507 19TH TER
BISBEE, AZ
ZIP 85603-705
Phone: (520) 255-2158

The provider's authorized official is Angela Saavedra .
The authorized official title is President/ceo and has the following contact phone number (520) 255-2158.

The enumeration date for this NPI number is 1/31/2024 and was last updated on 2/16/2024.

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	Primary
1	163WA0400X	Registered Nurse	Addiction (Substance Use Disorder)	No
2	207QA0505X	Family Medicine	Adult Medicine	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	No
4	163W00000X	Registered Nurse		No
5	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
6	101YP1600X	Counselor	Pastoral	No
7	106S00000X	Behavior Technician		No
8	133V00000X	Dietitian, Registered		No
9	324500000X	Substance Abuse Rehabilitation Facility		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	1962572008	MEDICAID	ARIZONA
2	1518503945	MEDICAID	ARIZONA

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: 5/5/2024

NPI Synchronization or Removal

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