Healthcare Provider Details

I. General information

NPI: 1275292096
Provider Name (Legal Business Name): BREAKTHROUGH THERAPEUTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2021
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7750 OKEECHOBEE BLVD STE 4-1032
WEST PALM BEACH FL
33411-2104
US

IV. Provider business mailing address

7750 OKEECHOBEE BLVD STE 4-1032
WEST PALM BEACH FL
33411-2104
US

V. Phone/Fax

Practice location:
  • Phone: 561-247-5550
  • Fax:
Mailing address:
  • Phone: 561-247-5550
  • Fax:

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
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BILLINE JOURDAN
Title or Position: CLINICAL PSYCHOLOGIST
Credential:
Phone: 617-869-1208