Provider Demographics
NPI:1164066395
Name:BREAKING BARRIERS - HOPE IS ALIVE
Entity Type:Organization
Organization Name:BREAKING BARRIERS - HOPE IS ALIVE
Other - Org Name:HOPE UNITED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:BORNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:CDCA
Authorized Official - Phone:330-414-5960
Mailing Address - Street 1:PO BOX 534
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-0534
Mailing Address - Country:US
Mailing Address - Phone:330-520-8700
Mailing Address - Fax:
Practice Address - Street 1:1920 SCHNEIDER ST NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44721-3352
Practice Address - Country:US
Practice Address - Phone:330-414-5960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-31
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Multi-Specialty