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General NPI Number Information
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NPI Number | 1548509896
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Entity Type | Organization
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Legal Business Name | BREAKTHROUGHS OUTPATIENT TREATMENT
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Dates
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Enumeration Date | 02/06/2013
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 704 I ST STE B
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City | MODESTO
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State | CA
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Zip | 95354-2224
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Country | US
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Telephone | 209-529-1855
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Fax | 209-529-1882
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Provider Business Mailing Address
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Address Line | 704 I ST STE B
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City | MODESTO
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State | CA
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Zip | 95354-2224
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Country | US
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Telephone | 209-529-1855
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Fax | 209-529-1882
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. DOROTHY J FRANKLIN
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Credential | R.A.S.
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Telephone | 209-613-3136
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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 | CA
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