Healthcare Provider Details

I. General information

NPI: 1144897281
Provider Name (Legal Business Name): BREAKTHROUGH ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2021
Last Update Date: 11/22/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16410 CYPRESS ROSEHILL RD
CYPRESS TX
77429-1428
US

IV. Provider business mailing address

2500 WILCREST DR. SUITE 300 PMB 300-009
HOUSTON TX
77042
US

V. Phone/Fax

Practice location:
  • Phone: 281-899-0146
  • Fax: 346-299-9049
Mailing address:
  • Phone: 647-280-2004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: HEBA MOHAMED SALEM
Title or Position: FOUNDER AND CEO
Credential: BCBA
Phone: 647-280-2004