Provider Demographics
NPI:1932377009
Name:BREAKTHROUGH, INC.
Entity type:Organization
Organization Name:BREAKTHROUGH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:H
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:919-493-2791
Mailing Address - Street 1:6 CONSULTANT PL # 100
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-3598
Mailing Address - Country:US
Mailing Address - Phone:919-493-2791
Mailing Address - Fax:
Practice Address - Street 1:6 CONSULTANT PL # 100
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-3598
Practice Address - Country:US
Practice Address - Phone:919-493-2791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301002PMedicaid
NC8301002BMedicaid
NC8301002GMedicaid
NC8301002QMedicaid