MEDICARE: BEYOND BREAKTHROUGH LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1942141585
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEYOND BREAKTHROUGH LLC

Provider Business Mailing Address
First Line	:	PO BOX 160
Second Line	:
City	:	HARRISBURG
State	:	NC
Zip	:	28075-0160
Country	:	US
Telephone Number	:	980-939-4137
Fax Number	:

Provider Business Practice Location Address
First Line	:	3299 OULTEN ST SW
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28027-2728
Country	:	US
Telephone Number	:	980-939-4137
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	AMI M PATEL
Credential	:
Telephone Number	:	980-939-4137

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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Directions to “BEYOND BREAKTHROUGH LLC ” Practice Location

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