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Organization
BREAKAWAY HEALTH CORPORATION
Active
Organization
BREAKAWAY HEALTH CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANNAH PLASKETT (CFO)
(714) 957-8229
Entity
Organization
Contact information
Practice address
3151 AIRWAY AVE # D-1D2, COSTA MESA, CA 92626-4607
(714) 957-8229
(714) 957-0244
Mailing address
3151 AIRWAY AVE STE D1, COSTA MESA, CA 92626-4622
(714) 957-8229
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
300065A
CA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
NULL
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
NULL
Other
Enumeration date
10/21/2006
Last updated
10/01/2024
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