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Organization

THE BREAKAWAY CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELLE M COCHRAN LCSW (BOARD MEMBER)
(502) 664-7987
Entity
Organization

Contact information

Practice address
1514 E SPRING ST, NEW ALBANY, IN 47150-2844
(812) 941-4177
Mailing address
1514 E SPRING ST, NEW ALBANY, IN 47150-2844
(812) 941-4177

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary

Other

Enumeration date
03/12/2019
Last updated
03/12/2019
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