Healthcare Provider Details

I. General information

NPI: 1184049421
Provider Name (Legal Business Name): BREAKTHROUGH RECOVERY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2014
Last Update Date: 02/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 NW 5TH AVE
OKEECHOBEE FL
34972-4140
US

IV. Provider business mailing address

202 NW 5TH AVE
OKEECHOBEE FL
34972-4140
US

V. Phone/Fax

Practice location:
  • Phone: 863-467-2300
  • Fax:
Mailing address:
  • Phone: 863-467-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. MADELINE KELLER LAMBERTI
Title or Position: EXECUTIVEDIRECTOR
Credential:
Phone: 863-467-2300