Organization
BREAKING BARRIERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY MICHAEL WELSH (DIRECTOR OF SERVICES)
(952) 303-3489
Entity
Organization
Contact information
Practice address
14500 BURNHAVEN DR STE 123, BURNSVILLE, MN 55306-4926
(952) 303-3489
Mailing address
14500 BURNHAVEN DR STE 123, BURNSVILLE, MN 55306-4926
(952) 303-3489
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6352077
MN DHS LICENSING
MN
Enumeration date
12/12/2017
Last updated
12/12/2017
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