MEDICARE: BREAKTHROUGH BEHAVIORAL HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1790309896
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BREAKTHROUGH BEHAVIORAL HEALTH

Provider Business Mailing Address
First Line	:	4801 S LAKESHORE DR STE 106
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-7156
Country	:	US
Telephone Number	:	480-525-0058
Fax Number	:	480-684-3060

Provider Business Practice Location Address
First Line	:	4801 S LAKESHORE DR STE 106
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-7156
Country	:	US
Telephone Number	:	480-525-0058
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BRIAN SILLANPAA
Credential	:	LPC
Telephone Number	:	480-525-0058

Provider Enumeration Date	:	06/04/2020
Last Update Date	:	10/11/2024

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