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SECOND CHANCE HEALTH & WELLNESS LLC
NPI 1194536425
Clinic/Center - Community Health in Jackson, MS

Active since January 16, 2025CLIA 25D2318117 · Waiver
11 NORTHTOWN DR STE 225, JACKSON, MS 39211(601) 842-4718 Get Directions Write a Review

NPPES record last updated: January 16, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Second Chance Health & Wellness Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SECOND CHANCE HEALTH & WELLNESS LLC (NPI 1194536425) is a healthcare organization registered as a community health in Jackson, Mississippi and active in the NPI registry since January 2025. The organization holds a CLIA Waiver certificate valid through February 4, 2027 and lists Devin Foster, Cec/founder, as its authorized official.

NPPES Registry Identity

NPI1194536425
Entity TypeOrganization
Primary Taxonomy261QC1500X
Legal Business NameSECOND CHANCE HEALTH & WELLNESS LLC
Location Address11 NORTHTOWN DR STE 225Jackson, MS 39211-3698
Mailing Address15 Oakford CtJackson, MS 39211-3050
Phone(601) 842-4718
Organization SubpartNo
Authorized OfficialDevin FosterCec/founder · (601) 842-4718
Enumeration DateJanuary 16, 2025
NPPES CertifiedJanuary 16, 2025
✔ NPI 1194536425 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ Primary SpecialtyClinic/Center · Community HealthAmbulatory Health Care Facilities
Taxonomy Code261QC1500X
Also ListedLocal Education Agency (LEA)Taxonomy 251300000X
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
Also ListedClinic/Center · Family Planning, Non-SurgicalTaxonomy 261QF0050X
Also ListedClinic/Center · Health ServiceTaxonomy 261QH0100X
Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X
Also ListedClinic/Center · Student HealthTaxonomy 261QS1000X
11 NORTHTOWN DR STE 225, Jackson, MS 39211
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 25D2318117

Second Chance Health & Wellness, LLC · Jackson, MS
Active · expires Feb 4, 2027
CLIA Number25D2318117
Laboratory TypeCommunity Clinic
Certificate Effective DateFebruary 5, 2025
Certificate Expiration DateFebruary 4, 2027
Laboratory DirectorDevin Foster
Laboratory Phone(601) 842-4718
Laboratory LocationSecond Chance Health & Wellness, LLC11 Northtown Drive, Suite 225, Rm 1, Jackson, MS 39211
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Second Chance Health & Wellness LLC's NPI number?

The NPI number for Second Chance Health & Wellness LLC is 1194536425. It was assigned to this organization in the NPPES registry on January 16, 2025.

Where is Second Chance Health & Wellness LLC located?

Second Chance Health & Wellness LLC is located at 11 Northtown Dr Ste 225, Jackson, MS 39211. The listed phone number is (601) 842-4718.

What is Second Chance Health & Wellness LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Community Health, with taxonomy code 261QC1500X.

Does Second Chance Health & Wellness LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2318117) is associated with this NPI, valid through February 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Second Chance Health & Wellness LLC was last updated on January 16, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.