BREAK OUT LLC NPI 1730377789

NPI Information

NPI: 1730377789
Provider Name: BREAK OUT LLC
Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
412 PINELAND AVE
DURHAM, NC
ZIP 27704
Phone: (919) 220-2181
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BREAK OUT LLC is a community based residential treatment facility mental illness in Durham, NC. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. BREAK OUT LLC NPI is 1730377789. The provider is registered as an organization entity type.

The provider's business location address is:

412 PINELAND AVE
DURHAM, NC
ZIP 27704-911
Phone: (919) 220-2181

The provider's authorized official is Darnella Lorraine Warthen .
The authorized official title is Owner/executive Director and has the following contact phone number (919) 477-4785.

The enumeration date for this NPI number is 10/3/2007 and was last updated on 10/3/2007.

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	320800000X	Community Based Residential Treatment Facility, Mental Illness		032414	NORTH CAROLINA	Yes

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: 4/28/2024

NPI Synchronization or Removal

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