| Breakthrough Mental Healthcare Llc | |
|
6136 Frisco Square Blvd Ste 400 Frisco TX 75034-3251 | |
| (469) 287-5505 | |
| Not Available |
| Full Name | Breakthrough Mental Healthcare Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6136 Frisco Square Blvd Ste 400, Frisco, Texas |
| Authorized Official Name and Position | Tonia Michelle Ajamu (PMHNP-BC) |
| Authorized Official Contact | 2142238150 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Breakthrough Mental Healthcare Llc 17304 Preston Rd Ste 800 Dallas TX 75252-5645 Ph: (214) 223-8150 | Breakthrough Mental Healthcare Llc 6136 Frisco Square Blvd Ste 400 Frisco TX 75034-3251 Ph: (469) 287-5505 |
| NPI Number | 1932701828 |
|---|---|
| Provider Enumeration Date | 11/15/2020 |
| Last Update Date | 03/06/2024 |
| Certification Date | 03/06/2024 |
| Medicare PECOS PAC ID | 7810306610 |
|---|---|
| Medicare Enrollment ID | O20210507000320 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932701828 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Tonia Michelle Ajamu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881226793 PECOS PAC ID: 8729497524 Enrollment ID: I20210602001327 |
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