Healthcare Provider Details

I. General information

NPI: 1881402071
Provider Name (Legal Business Name): BREAKING THE CYCLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2024
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7950 W KING ST STE 102
BOISE ID
83704-7157
US

IV. Provider business mailing address

24871 S ELLSWORTH RD
QUEEN CREEK AZ
85142-1574
US

V. Phone/Fax

Practice location:
  • Phone: 480-299-2385
  • Fax:
Mailing address:
  • Phone: 480-299-2385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: BROOKE SGUARDO
Title or Position: VP OF PROGRAM INTEGRITY
Credential:
Phone: 480-299-2385