| Breaking The Cycle, Llc | |
|
112 S Providence Rd Ste 201 North Chesterfield VA 23236-3300 | |
| (804) 822-0236 | |
| (804) 660-6571 |
| Full Name | Breaking The Cycle, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 112 S Providence Rd Ste 201, North Chesterfield, Virginia |
| Authorized Official Name and Position | Quatysha Nia Jackson (OWNER) |
| Authorized Official Contact | 8048220236 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Breaking The Cycle, Llc 112 S Providence Rd Ste 201 North Chesterfield VA 23236-3300 Ph: (804) 822-0236 | Breaking The Cycle, Llc 112 S Providence Rd Ste 201 North Chesterfield VA 23236-3300 Ph: (804) 822-0236 |
| NPI Number | 1689397523 |
|---|---|
| Provider Enumeration Date | 09/26/2022 |
| Last Update Date | 05/08/2024 |
| Certification Date | 05/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689397523 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
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