Organization Active NPI

Breakwater Behavioral Health & Recovery Services LLC

  • Community/Behavioral Health Agency
  • Peabody, MA
National Provider Identifier
1417813312
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
BREAKWATER BEHAVIORAL HEALTH & RECOVERY SERVICES LLC
Practice address
9 Centennial Dr Unit 202
Peabody, MA 01960-7940
Phone
(978) 233-1823
NPI assigned
Jan 5, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Authorized official

Name
Jason Favaloro
Title
Managing Member
Phone
(978) 233-1823

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

9 Centennial Dr Unit 202
Peabody, MA 01960-7940

Mailing address

9 Centennial Dr Unit 202
Peabody, MA 01960-7940
Phone (978) 233-1823

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1767571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767571200000",
    "number": "1417813312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CENTENNIAL DR UNIT 202",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019607940",
            "telephone_number": "978-233-1823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 CENTENNIAL DR UNIT 202",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019607940",
            "telephone_number": "978-233-1823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAKWATER BEHAVIORAL HEALTH & RECOVERY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-05",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A",
        "authorized_official_last_name": "FAVALORO",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "978-233-1823"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; 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.