Provider Demographics
NPI:1982383386
Name:BREAK THE CYCLE BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:BREAK THE CYCLE BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHYRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SKIPWITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-851-5092
Mailing Address - Street 1:1301 YORK ROAD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:LUTHERVILLE-TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093
Mailing Address - Country:US
Mailing Address - Phone:410-769-3255
Mailing Address - Fax:
Practice Address - Street 1:3536 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:UNITED STATES
Practice Address - Zip Code:21215
Practice Address - Country:VE
Practice Address - Phone:410-769-3255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility