Provider Demographics
NPI:1992904981
Name:BREAKTHROUGH REHAB, INC.
Entity type:Organization
Organization Name:BREAKTHROUGH REHAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAYLE
Authorized Official - Middle Name:MARI
Authorized Official - Last Name:TADA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:808-753-7617
Mailing Address - Street 1:3465 WAIALAE AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-2650
Mailing Address - Country:US
Mailing Address - Phone:808-753-7617
Mailing Address - Fax:808-735-3556
Practice Address - Street 1:3465 WAIALAE AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-2650
Practice Address - Country:US
Practice Address - Phone:808-753-7617
Practice Address - Fax:808-735-3556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment