| Breakaway Iop Llc | |
|
7 Beaverdam Rd Asheville NC 28804-6626 | |
| (828) 707-0250 | |
| Not Available |
| Full Name | Breakaway Iop Llc |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 7 Beaverdam Rd, Asheville, North Carolina |
| Authorized Official Name and Position | Grady Braxton Jefferys (PROGRAM DIRECTOR) |
| Authorized Official Contact | 8282731643 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Breakaway Iop Llc 213 Meadow Run Ext Asheville NC 28806-9787 Ph: (828) 707-0250 | Breakaway Iop Llc 7 Beaverdam Rd Asheville NC 28804-6626 Ph: (828) 707-0250 |
| NPI Number | 1518349034 |
|---|---|
| Provider Enumeration Date | 06/20/2015 |
| Last Update Date | 06/20/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518349034 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
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