Second Chance Ranch

NPI #1093041766 in Paron, Arkansas

Provider Information

NPI Number: 1093041766
Entity Type: Organization
Organization Name: Second Chance Ranch
Primary Specialty: Point of Service
Enumeration Date: Oct 30, 2009
Last Updated: Oct 30, 2009

Practice Location

Address: 201 DESTINED TO WIN ROAD
City: Paron
State: Arkansas
ZIP Code: 72122
Phone: (501) 847-1559

Authorized Official

Name: MR. NATHAN WINIECKI, MHPP
Title: CASE MANAGER/TEACHER
Phone: (501) 847-1559

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Point of Service	305S00000X	Primary

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