Provider Demographics
NPI:1912424433
Name:BRAKING POINT RECOVERY CENTER
Entity Type:Organization
Organization Name:BRAKING POINT RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MARIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-270-2380
Mailing Address - Street 1:45 N CANFIELD NILES RD FL 3
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2343
Mailing Address - Country:US
Mailing Address - Phone:330-270-2380
Mailing Address - Fax:330-270-2383
Practice Address - Street 1:45 N CANFIELD NILES RD FL 3
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2343
Practice Address - Country:US
Practice Address - Phone:330-270-2380
Practice Address - Fax:330-270-2383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0129422Medicaid