Organization
BREAKING THE CYCLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. QUATYSHA NIA JACKSON LCSW (OWNER)
(804) 822-0236
Entity
Organization
Contact information
Practice address
112 S PROVIDENCE RD STE 201, NORTH CHESTERFIELD, VA 23236-3300
(804) 822-0236
(804) 660-6571
Mailing address
112 S PROVIDENCE RD STE 201, NORTH CHESTERFIELD, VA 23236-3300
(804) 822-0236
(804) 660-6571
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
09/26/2022
Last updated
05/08/2024
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