Organization · NPI-2

Broken Pieces Services LLC

Community/Behavioral Health · Gastonia, NC

NPI number1265959100

StatusActive

Last updated in NPPESAug 15, 2023

Details

NPI: 1265959100
Entity type: Organization (NPI-2)
Legal business name: Broken Pieces Services LLC
Organization subpart: No
Enumeration date: Aug 22, 2017
Certification date: Aug 15, 2023
Last updated: Aug 15, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
251S00000X	Community/Behavioral Health	–	–	Yes
101YA0400X	Counselor, Addiction (Substance Use Disorder)	–	–
101YM0800X	Counselor, Mental Health	–	–
1041C0700X	Social Worker, Clinical	–	–
106S00000X	Behavior Technician	–	–
175T00000X	Peer Specialist	–	–
252Y00000X	Early Intervention Provider Agency	–	–
253Z00000X	In Home Supportive Care	–	–
374U00000X	Home Health Aide	–	–
385H00000X	Respite Care	–	–
385HR2055X	Respite Care, Respite Care, Mental Illness, Child	–	–
385HR2065X	Respite Care, Respite Care, Physical Disabilities, Child	–	–

Practice location

2020 Remount Rd
Gastonia, NC 28054-7476

Phone 980-355-3737

Mailing address

2020 Remount Rd Ste G-100b
Gastonia, NC 28054-7476

Phone 980-355-3737

Other practice locations

8021 Bella Vista Ct
Charlotte, NC 28216-2043

Phone 980-258-9315

706 Lazy Oak Ct
Clover, SC 29710-7848

Phone 980-258-9315

Authorized official

Marquita Russell
Operations
9802589315

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.