Provider Demographics
NPI:1851792527
Name:BREAKING CHAINS COMMUNITY SERVICES
Entity Type:Organization
Organization Name:BREAKING CHAINS COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/C.E.O
Authorized Official - Prefix:
Authorized Official - First Name:JASHAE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-515-1018
Mailing Address - Street 1:7501 TRAFALGAR CIR
Mailing Address - Street 2:APT 355
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-5008
Mailing Address - Country:US
Mailing Address - Phone:410-993-1643
Mailing Address - Fax:
Practice Address - Street 1:7501 TRAFALGAR CIR
Practice Address - Street 2:APT 355
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-5008
Practice Address - Country:US
Practice Address - Phone:410-993-1643
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management