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General NPI Number Information
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NPI Number | 1063384915
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Entity Type | Organization
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Legal Business Name | BREAKTHROUGH LLC
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Dates
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Enumeration Date | 09/20/2025
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Last Update Date | 09/20/2025
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Provider Practice Location Address
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Address Line | 9800 CONNECTICUT DR
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City | CROWN POINT
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State | IN
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Zip | 46307-7840
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Country | US
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Telephone | 708-491-8520
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Fax |
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Provider Business Mailing Address
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Address Line | 24255 S KLEMME RD
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City | CRETE
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State | IL
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Zip | 60417-2605
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Country | US
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Telephone | 708-491-8520
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. LAKEISHA SMITH
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Credential |
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Telephone | 708-491-8520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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