Provider Demographics
NPI:1548509896
Name:BREAKTHROUGHS OUTPATIENT TREATMENT
Entity type:Organization
Organization Name:BREAKTHROUGHS OUTPATIENT TREATMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:RAS
Authorized Official - Phone:209-613-3136
Mailing Address - Street 1:704 I ST STE B
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95354-2224
Mailing Address - Country:US
Mailing Address - Phone:209-529-1855
Mailing Address - Fax:209-529-1882
Practice Address - Street 1:704 I ST STE B
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95354-2224
Practice Address - Country:US
Practice Address - Phone:209-529-1855
Practice Address - Fax:209-529-1882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-06
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health