Organization Active NPI

Chance 2 Change

Doing business as Break the Cycle

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Palatka, FL
National Provider Identifier
1073313177
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
CHANCE 2 CHANGE
Doing business as
Break the Cycle
Practice address
216 S 6TH St Ste 3
Palatka, FL 32177-4608
Phone
(386) 333-9622
NPI assigned
Mar 17, 2025
Last updated
Mar 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kimberly A Young
Title
Ceo
Phone
(386) 333-9622

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

216 S 6TH St Ste 3
Palatka, FL 32177-4608

Mailing address

724 S Beach St Ste 3
Daytona Beach, FL 32114-5412
Phone (386) 333-9622

Other names 1

  • BREAK THE CYCLE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Break the Cycle4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

724 S Beach St
Ste 3
Daytona Beach, FL 32114
Phone (386) 437-0235

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1742169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742169600000",
    "number": "1073313177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 S BEACH ST STE 3",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321145412",
            "telephone_number": "386-333-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 S 6TH ST STE 3",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321774608",
            "telephone_number": "386-333-9622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANCE 2 CHANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-17",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "386-333-9622"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BREAK THE CYCLE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palatka, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.