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General NPI Number Information
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NPI Number | 1144821539
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Entity Type | Organization
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Legal Business Name | CPF BREAKTHROUGH, LLC
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Dates
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Enumeration Date | 11/03/2020
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Last Update Date | 01/31/2024
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Provider Practice Location Address
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Address Line | 11711 E SPRAGUE AVE STE D4
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City | SPOKANE VALLEY
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State | WA
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Zip | 99206-6122
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Country | US
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Telephone | 509-927-6838
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Fax | 509-927-6845
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Provider Business Mailing Address
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Address Line | 11711 E SPRAGUE AVE STE D4
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City | SPOKANE VALLEY
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State | WA
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Zip | 99206-6122
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Country | US
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Telephone | 509-927-6838
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Fax | 509-927-6845
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | LISA F PARKER
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Credential | NCACII, SUDP
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Telephone | 509-927-6838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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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 #5
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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