Provider Demographics
NPI:1437904687
Name:BREAKING ALL BARRIERS LLC
Entity type:Organization
Organization Name:BREAKING ALL BARRIERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAWANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TYSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, SWA
Authorized Official - Phone:216-905-3080
Mailing Address - Street 1:3558 E 142ND ST APT 1
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-5805
Mailing Address - Country:US
Mailing Address - Phone:216-905-3080
Mailing Address - Fax:
Practice Address - Street 1:3558 E 142ND ST APT 1
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-5805
Practice Address - Country:US
Practice Address - Phone:216-905-3080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)