Healthcare Provider Details

I. General information

NPI: 1255279543
Provider Name (Legal Business Name): BREAKING THE CHAINS 23
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 E DAKOTA AVE
FRESNO CA
93726-4804
US

IV. Provider business mailing address

PO BOX 9751
FRESNO CA
93794-9751
US

V. Phone/Fax

Practice location:
  • Phone: 559-492-1566
  • Fax:
Mailing address:
  • Phone: 559-492-1566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: KARA GRASMICK
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 559-492-1566