Provider Demographics
NPI:1164200465
Name:BREEZE MENTAL HEALTH PLLC
Entity Type:Organization
Organization Name:BREEZE MENTAL HEALTH PLLC
Other - Org Name:BREEZE MENTAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:RED
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:570-539-7234
Mailing Address - Street 1:305 LINDEN ST FL 4
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18503-1430
Mailing Address - Country:US
Mailing Address - Phone:740-422-9589
Mailing Address - Fax:
Practice Address - Street 1:5626 FRANTZ RD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-1559
Practice Address - Country:US
Practice Address - Phone:570-539-7234
Practice Address - Fax:570-302-4238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-18
Last Update Date:2024-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No251J00000XAgenciesNursing Care
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty