Provider Demographics
NPI:1881402071
Name:BREAKING THE CYCLE LLC
Entity type:Organization
Organization Name:BREAKING THE CYCLE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF PROGRAM INTEGRITY
Authorized Official - Prefix:
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:SGUARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-299-2385
Mailing Address - Street 1:24871 S ELLSWORTH RD
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-1574
Mailing Address - Country:US
Mailing Address - Phone:480-299-2385
Mailing Address - Fax:
Practice Address - Street 1:7950 W KING ST STE 102
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-7157
Practice Address - Country:US
Practice Address - Phone:480-299-2385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-20
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder