Active NPI
Breakwater Behavioral Health & Recovery Services LLC
- Community/Behavioral Health Agency
- Peabody, MA
National Provider Identifier
1417813312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 DirectoryNPI 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.