Provider Demographics
NPI:1174370506
Name:JUST BREATHE RECOVERY AND WELLNESS CENTERS, LLC
Entity type:Organization
Organization Name:JUST BREATHE RECOVERY AND WELLNESS CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KARA
Authorized Official - Middle Name:CAPRIE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C, LCSW
Authorized Official - Phone:330-256-3850
Mailing Address - Street 1:14306 KATHLEEN LN
Mailing Address - Street 2:
Mailing Address - City:BRANDYWINE
Mailing Address - State:MD
Mailing Address - Zip Code:20613-3012
Mailing Address - Country:US
Mailing Address - Phone:330-256-3850
Mailing Address - Fax:
Practice Address - Street 1:14306 KATHLEEN LN
Practice Address - Street 2:
Practice Address - City:BRANDYWINE
Practice Address - State:MD
Practice Address - Zip Code:20613-3012
Practice Address - Country:US
Practice Address - Phone:330-256-3850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)