# BREAKAWAY HEALTH CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851474225
- **Authorized official:** HANNAH PLASKETT (CFO)
- **Authorized official phone:** (714) 957-8229

## Contact information

- **Practice address:** 3151 AIRWAY AVE \# D-1D2, COSTA MESA, CA 92626-4607
- **Practice address phone:** (714) 957-8229
- **Practice address fax:** (714) 957-0244
- **Mailing address:** 3151 AIRWAY AVE STE D1, COSTA MESA, CA 92626-4622
- **Mailing address phone:** (714) 957-8229

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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) | — | NULL | Yes |
| 261QR0405X | Substance Use Disorder Rehabilitation Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 10/21/2006
- **Last updated:** 10/01/2024