BREAK OUT LLC (NPI# 1730377789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730377789 |
| Entity Type | Organization |
| Organization Name | BREAK OUT LLC |
| Practice Address |
412 Pineland Ave Durham NC 27704-2911 |
| Mailing Address |
406 Mare Ct Bahama NC 27503-9615 |
| Practice Telephone | 9192202181 |
| Mailing Telephone | 9194774785 |
| Enumeration Date | 2007-10-03 |
| Last Update Date | 2007-10-03 |
| Authorized Official Name | DARNELLA LORRAINE WARTHEN (OWNER/EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9194774785 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 032414 | NC | Residential Treatment Facilities |
| Street Address |
412 PINELAND AVE |
| City | DURHAM |
| State | NC |
| Zip Code | 27704-2911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245723139 | Devang Ashokbhai Patel | Dentist | 2609 N Duke St Ste 618, Durham, NC 27704 | 2018-06-14 |
| 1891201042 | Little Family Care Home, LLC | Custodial Care Facility | 1012 Davinci Street, Durham, NC 27704 | 2017-12-26 |
| 1033625702 | Tondra A Little | Social Worker | 2804 Nellowood Street, Durham, NC 27704 | 2017-12-18 |
| 1437502408 | Jhazmere Shamas Preston | Counselor | 2609 N. Duke St. Suite 403, Durham, NC 27704 | 2016-07-14 |
| 1649626656 | Professional Elevations Pllc | Case Manager/Care Coordinator | 304 Crutchfield Drive, Durham, NC 27704 | 2016-05-09 |
| 1083071617 | Alyssa Wilson | Speech-Language Pathologist | 215 William Penn Plz Apt 908, Durham, NC 27704 | 2016-01-27 |
| 1932565124 | Arthur Reynolds Jr and Associates P.l.l.c. | Dentist | 2106 N Duke St, Durham, NC 27704 | 2016-01-05 |
| 1962877720 | Chimere Brooks | Contractor | 4001meriwether Drive Apt P-19, Durham, NC 27704 | 2015-12-04 |
| 1184013294 | Danielle King | Physician Assistant | 3611 N Duke Street, Durham, NC 27704 | 2015-01-13 |
| 1730581901 | Images, 'of Me To You' | Community/Behavioral Health | 2823 Cascadilla Street, Durham, NC 27704 | 2014-09-19 |
| Find all providers in zip 27704 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093253478 | Tree of Life Transportation | Community Based Residential Treatment Facility, Mental Illness | 5067 Rainmaker Dr, Durham, NC 27704-2299 | 2017-02-06 |
| 1538421821 | Seven Oaks Family Care Home Inc | Community Based Residential Treatment Facility, Mental Illness | 234 Seven Oaks Rd, Durham, NC 27704-1125 | 2012-06-12 |
| 1164667036 | Anfo Children and Adult Services | Community Based Residential Treatment Facility, Mental Illness | 3604 Witherspoon Blvd, Suite 111, Pmb 233, Durham, NC 27707-6850 | 2008-12-08 |
| 1942445903 | Universal Care and Development | Community Based Residential Treatment Facility, Mental Illness | 910 Belvin Ave, Durham, NC 27704-3332 | 2008-12-04 |
| 1154589208 | The Mental Health Association In Nc, Inc | Community Based Residential Treatment Facility, Mental Illness | 708 Raynor St, Apt A-1, Durham, NC 27703-2239 | 2008-05-27 |
| 1922273960 | The Mental Health Association In North Carolina, Inc | Community Based Residential Treatment Facility, Mental Illness | 409 Ebon Rd, Durham, NC 27713-1621 | 2008-04-29 |
| 1114192259 | The Mental Health Association In North Carolina, Inc | Community Based Residential Treatment Facility, Mental Illness | 1524 Southwood Dr, Durham, NC 27707-2114 | 2008-04-29 |
| 1225207491 | Resources for Human Development, Inc. | Community Based Residential Treatment Facility, Mental Illness | 947 Clarion Dr, Durham, NC 27705-1730 | 2008-02-21 |
| 1508049107 | Removing Mountains | Community Based Residential Treatment Facility, Mental Illness | 1115 Chalk Level Road, Durham, NC 27704-1527 | 2007-12-06 |
| 1164611760 | New Horizon | Community Based Residential Treatment Facility, Mental Illness | 801 Lorain Ave, Durham, NC 27704-3023 | 2007-10-18 |
| Find all providers in DURHAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.