Provider Demographics
NPI:1396599734
Name:BREAKTHROUGH MENTAL HEALTH LLC
Entity type:Organization
Organization Name:BREAKTHROUGH MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:STANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:302-423-0570
Mailing Address - Street 1:10278 S DUPONT HWY
Mailing Address - Street 2:
Mailing Address - City:FELTON
Mailing Address - State:DE
Mailing Address - Zip Code:19943-5626
Mailing Address - Country:US
Mailing Address - Phone:302-330-7727
Mailing Address - Fax:302-330-8413
Practice Address - Street 1:10278 S DUPONT HWY
Practice Address - Street 2:
Practice Address - City:FELTON
Practice Address - State:DE
Practice Address - Zip Code:19943-5626
Practice Address - Country:US
Practice Address - Phone:302-330-7727
Practice Address - Fax:302-330-8413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty