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General NPI Number Information
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NPI Number | 1871781211
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Entity Type | Organization
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Legal Business Name | BREAK THRU MINISTRIES
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Dates
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Enumeration Date | 10/11/2007
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Last Update Date | 10/11/2007
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Provider Practice Location Address
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Address Line | 3552 GREEN AVE SUITE 102
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-3243
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Country | US
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Telephone | 562-431-1799
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Fax | 562-799-9219
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Provider Business Mailing Address
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Address Line | 3552 GREEN AVE SUITE 102
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-3243
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Country | US
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Telephone | 562-431-1799
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Fax | 562-799-9219
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Authorized Official
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Title or Position | DIRECTOR/PRESIDENT
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Name | MRS. DYAN HOWK
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Credential | M.F.T., REVEREND
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Telephone | 714-828-0127
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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 | MFC34851
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MFC43015
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MFC 20752
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License Number State | CA
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