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Organization

BREAKING FREE OF ADDICTION

Active
Parent organization
CHRISTY LENNOX
Organization subpart
Yes

Provider details

NPI number
Legal business name
CHRISTY LENNOX
Authorized official
CHRISTY LENNOX CADC II, ICADC, SAP (CD COUNSELOR)
(951) 443-9758
Entity
Organization

Contact information

Practice address
29399 PIERCE AVE, LAKE ELSINORE, CA 92530-4832
(951) 443-9758
Mailing address
5790 MAGNOLIA AVE STE 202, RIVERSIDE, CA 92506-1874
(941) 443-9758
(877) 811-7190

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
A8250912
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A8250912
CERTIFICATION
Enumeration date
10/08/2015
Last updated
10/08/2015
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