Provider Demographics
NPI:1427541424
Name:BREAKING FREE TRANSITIONAL SERVICES
Entity Type:Organization
Organization Name:BREAKING FREE TRANSITIONAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SAROYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:516-322-2535
Mailing Address - Street 1:734 FRANKLIN AVE STE 337
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-4525
Mailing Address - Country:US
Mailing Address - Phone:516-506-2400
Mailing Address - Fax:516-741-0120
Practice Address - Street 1:48 THORNE AVE
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-5707
Practice Address - Country:US
Practice Address - Phone:516-506-2400
Practice Address - Fax:516-741-0120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-13
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center