Provider Demographics
NPI:1700312097
Name:BREAKING CHAINS
Entity Type:Organization
Organization Name:BREAKING CHAINS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:RENE'
Authorized Official - Last Name:HATCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-229-8968
Mailing Address - Street 1:727 MILLS SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:VA
Mailing Address - Zip Code:24171-3886
Mailing Address - Country:US
Mailing Address - Phone:276-229-8968
Mailing Address - Fax:
Practice Address - Street 1:727 MILLS SCHOOL RD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:VA
Practice Address - Zip Code:24171-3886
Practice Address - Country:US
Practice Address - Phone:276-229-8968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-04
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health