NPIMap

Organization Active NPI

Breakaway Detox Centers

  • Substance Abuse Rehabilitation Facility
  • Fountain Valley, CA
National Provider Identifier
1639751373
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
BREAKAWAY DETOX CENTERS
Practice address
18779 Palm St
Fountain Valley, CA 92708-6428
Phone
(714) 916-0219
Fax
(714) 369-2577
NPI assigned
Apr 22, 2021
Last updated
Apr 22, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
BREAKAWAY HEALTH CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Authorized official

Name
Richard Plaskett
Title
Ceo
Phone
(714) 957-8229

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X NU Primary

Addresses

Primary practice location

18779 Palm St
Fountain Valley, CA 92708-6428

Mailing address

3151 Airway Ave Ste D1
Costa Mesa, CA 92626-4622
Phone (714) 957-8229

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address richard@breakawayhealth.com
Direct Messaging Address natalia@breakawayhealth.com

National Provider Directory

National Provider Directory
Tax ID family
Breakaway Health Corporation2 organizations share this tax ID, including this one
Part of
Breakaway Health Corporation

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1639751373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3151 AIRWAY AVE STE D1",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264622",
            "telephone_number": "714-957-8229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18779 PALM ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086428",
            "telephone_number": "714-916-0219",
            "fax_number": "714-369-2577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAKAWAY DETOX CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BREAKAWAY HEALTH CORPORATION",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "PLASKETT",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-957-8229"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "richard@breakawayhealth.com",
            "affiliation": "N",
            "address_1": "18779 Palm St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927086428",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "natalia@breakawayhealth.com",
            "affiliation": "N",
            "address_1": "18779 Palm St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927086428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; 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.