Healthcare Provider Details

I. General information

NPI: 1366395568
Provider Name (Legal Business Name): BREAKING CHAINS RECOVERY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
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: 440-969-0039
  • Fax: 440-740-3835
Mailing address:
  • Phone: 440-969-0039
  • Fax: 440-740-3835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

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