Healthcare Provider Details

I. General information

NPI: 1528854866
Provider Name (Legal Business Name): BREAKING CHAINS RECOVERY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4837 MAIN AVE
ASHTABULA OH
44004-6965
US

IV. Provider business mailing address

4837 MAIN AVE
ASHTABULA OH
44004-6965
US

V. Phone/Fax

Practice location:
  • Phone: 440-969-3039
  • Fax: 440-740-3835
Mailing address:
  • Phone: 440-969-3039
  • Fax: 440-740-3835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROBIN DEEMER
Title or Position: CEO/OWNER
Credential: LISW, LICDC
Phone: 440-969-3039