| Breakthrough Community Services Llc | |
|
1990 Spicetree Ln Se Salem OR 97306-3406 | |
| (503) 881-6034 | |
| Not Available |
| Full Name | Breakthrough Community Services Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1990 Spicetree Ln Se, Salem, Oregon |
| Authorized Official Name and Position | Colisha Jane Vanpelt (DSP) |
| Authorized Official Contact | 5038816034 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Breakthrough Community Services Llc 1990 Spicetree Ln Se Salem OR 97306-3406 Ph: (503) 881-6034 | Breakthrough Community Services Llc 1990 Spicetree Ln Se Salem OR 97306-3406 Ph: (503) 881-6034 |
| NPI Number | 1821707860 |
|---|---|
| Provider Enumeration Date | 11/18/2022 |
| Last Update Date | 11/18/2022 |
| Certification Date | 11/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821707860 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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