Provider Demographics
NPI:1154103893
Name:BREAKTHROUGH ABA LLC
Entity type:Organization
Organization Name:BREAKTHROUGH ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEMECHECK
Authorized Official - Suffix:
Authorized Official - Credentials:MS BCBA LBA
Authorized Official - Phone:541-350-8474
Mailing Address - Street 1:5450 SW RIM RD
Mailing Address - Street 2:
Mailing Address - City:TERREBONNE
Mailing Address - State:OR
Mailing Address - Zip Code:97760-7749
Mailing Address - Country:US
Mailing Address - Phone:541-350-8474
Mailing Address - Fax:
Practice Address - Street 1:5450 SW RIM RD
Practice Address - Street 2:
Practice Address - City:TERREBONNE
Practice Address - State:OR
Practice Address - Zip Code:97760-7749
Practice Address - Country:US
Practice Address - Phone:541-350-8474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty