Bondage Breaker Recovery Service

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

520003AN Issued in CA

Legal business name

BONDAGE BREAKER RECOVERY SERVICE

Practice address

224 Ash St
Red Bluff, CA 96080-3804

Phone

(530) 529-0634

Fax

(530) 529-0650

NPI assigned

May 20, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ross Dewayne Heggie, CAS

Title

Executive Director

Phone

(530) 529-0634

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1179619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265640403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8652",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960808652",
            "telephone_number": "530-529-0634",
            "fax_number": "530-529-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 ASH ST",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960803804",
            "telephone_number": "530-529-0634",
            "fax_number": "530-529-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONDAGE BREAKER RECOVERY SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HEGGIE",
        "authorized_official_first_name": "ROSS",
        "authorized_official_middle_name": "DEWAYNE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "530-529-0634",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CAS"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "520003AN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eddie Blanco
• Anita L. Blosser, M.D.
• Jorge Alejandro Bobadilla Parga
• Stacey Boek-Dominguez, M.S., R.D.
• Jessica Bolmanski
• Kati Boomgarden, FNP
• Rachel Layne Boomgarden, RDH
• Karen A Borm, RN
• Richard Lee Bradley
• Bianca Bradshaw, PHARM.D.

• Substance Abuse Rehabilitation Facility in Red Bluff, CA
• Providers in Red Bluff, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.