BREAKING FREE, LLC (NPI# 1629575212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629575212 |
| Entity Type | Organization |
| Organization Name | BREAKING FREE, LLC |
| Practice Address |
165 S Main St Lebanon OR 97355-4223 |
| Mailing Address |
Po Box 24 Jefferson OR 97352-0024 |
| Practice Telephone | 5414054622 |
| Practice Fax Number | 5414054381 |
| Mailing Telephone | 5413278099 |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2020-03-26 |
| Authorized Official Name | MS. TAMMY RENEA KROMHOUT (CO-OWNER) |
| Authorized Official Telephone | 5414054622 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500717667 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | BREAKING FREE, LLC | 1315 S. Crystal Way, Aurora, CO 80012 |
| Street Address |
165 S MAIN ST |
| City | LEBANON |
| State | OR |
| Zip Code | 97355-4223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861015307 | Meredith R. Whitmore | Counselor | 165 S Main St, Lebanon, OR 97355-4223 | 2020-05-19 |
| 1205463304 | Margaret Hull Yamasaki | Counselor | 165 S Main St, Lebanon, OR 97355-4223 | 2020-03-26 |
| 1225592033 | Christine J Dowd | Counselor | 165 S Main St, Lebanon, OR 97355-4223 | 2019-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710516182 | Patricia Hoangphuong Nguyen | Student in an Organized Health Care Education/Training Program | Western University of Health Sciences Comp-northwest, 200 Mullins Drive, Lebanon, OR 97355 | 2020-04-07 |
| 1528609740 | Liana Beaty | Technician | 31231 Mccraven Ln, Lebanon, OR 97355 | 2019-09-30 |
| 1710465323 | Jackie Welter | Health Educator | 35 Mullins Drvie Ste 3, Lebanon, OR 97355 | 2018-08-06 |
| 1518415371 | Kathleen Hillary | Registered Nurse | 525 North Santiam Highway, Lebanon, OR 97355 | 2016-09-21 |
| 1861849283 | Emily Marshall | Student in an Organized Health Care Education/Training Program | 200 Mullins Drive, Lebanon, OR 97355 | 2016-05-16 |
| 1033565551 | Celeste Maxine Croy-baker | Student in an Organized Health Care Education/Training Program | 200 Mullins Dr., Lebanon, OR 97355 | 2016-05-13 |
| 1770956963 | Jeff Parsons | Occupational Therapist | 600 Ne 5th St, Oregon Veterans Home, Lebanon, OR 97355 | 2015-11-10 |
| 1003289588 | Hong Ngoc Nguyen | Pharmacist | 675 N Fifth Street, Lebanon, OR 97355 | 2015-11-05 |
| 1801278049 | Darrel A Decker | Skilled Nursing Facility | 350 8th Street, Lebanon, OR 97355 | 2015-06-24 |
| 1679985113 | State of Oregon Department of Veterans' Affairs | Skilled Nursing Facility | 600 N. 5th Street, Lebanon, OR 97355 | 2014-06-02 |
| Find all providers in zip 97355 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154895712 | Lanham Counseling | Community/Behavioral Health | 27 Court Sq, Lebanon, KY 40033-1233 | 2019-01-17 |
| 1780119305 | Recovery Defined, LLC | Community/Behavioral Health | 777 Columbus Ave Ste 7d, Lebanon, OH 45036-1684 | 2017-04-21 |
| 1952712663 | Family Preservation Services, Inc. | Community/Behavioral Health | 53 Pruner St, Lebanon, VA 24266-4235 | 2014-05-15 |
| 1568772135 | T. W. Ponessa and Associates Counseling Services, Inc. | Community/Behavioral Health | 400 Narrows Drive, Lebanon, PA 17046 | 2010-10-18 |
| 1013227685 | T. W. Ponessa and Associates Counseling Services, Inc. | Community/Behavioral Health | 101 E. Evergreen Road, Lebanon, PA 17042 | 2010-10-18 |
| 1982854238 | T. W. Ponessa and Associates Counseling Services, Inc. | Community/Behavioral Health | 1825 S 5th Ave, Lebanon, PA 17042-7910 | 2008-09-23 |
| 1871743120 | T. W. Ponessa and Associates Counseling Services, Inc. | Community/Behavioral Health | 1600 Colonial Cir, Lebanon, PA 17046-1964 | 2008-09-23 |
| 1568619922 | James Dale Streiff | Community/Behavioral Health | 756 Cumberland St, Suite 3, Lebanon, PA 17042-5268 | 2008-08-27 |
| 1659528230 | Family Preservation Services, Inc | Community/Behavioral Health | George Ben Whited Drive, Lebanon, VA 24266 | 2008-08-26 |
| 1821263716 | O.c.c.s., Inc. | Community/Behavioral Health | 687 W Elm St, Lebanon, MO 65536-3568 | 2008-04-23 |
| Find all providers in LEBANON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.