Provider Demographics
NPI:1922427590
Name:BREAKING BOUNDARIES RECOVERY SERVICES, INC.
Entity Type:Organization
Organization Name:BREAKING BOUNDARIES RECOVERY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ISONNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:MARROW
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:808-312-1530
Mailing Address - Street 1:338 KAMOKILA BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2055
Mailing Address - Country:US
Mailing Address - Phone:808-312-1530
Mailing Address - Fax:808-744-6793
Practice Address - Street 1:338 KAMOKILA BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2055
Practice Address - Country:US
Practice Address - Phone:808-312-1530
Practice Address - Fax:808-744-6793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health