Provider Demographics
NPI:1538981246
Name:BREAK THE CYCLE BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:BREAK THE CYCLE BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHYRIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:LOUDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-851-5092
Mailing Address - Street 1:408
Mailing Address - Street 2:NORTHFIELDS COURT
Mailing Address - City:EDGEWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21040
Mailing Address - Country:US
Mailing Address - Phone:443-851-5092
Mailing Address - Fax:
Practice Address - Street 1:5117 CORDELIA AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215
Practice Address - Country:US
Practice Address - Phone:443-869-6880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BREAK THE CYCLE BEHAVIORAL HEALTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility