Provider Demographics
NPI:1992482061
Name:BREAKTHROUGH CLINICAL SERVICES LLC
Entity type:Organization
Organization Name:BREAKTHROUGH CLINICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:J
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:757-542-3888
Mailing Address - Street 1:4338 FORT HUGER DR
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23430-5364
Mailing Address - Country:US
Mailing Address - Phone:757-542-3888
Mailing Address - Fax:757-542-3890
Practice Address - Street 1:4338 FORT HUGER DR
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:VA
Practice Address - Zip Code:23430-5364
Practice Address - Country:US
Practice Address - Phone:757-542-3888
Practice Address - Fax:757-542-3890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty