Provider Demographics
NPI:1083053854
Name:BREAKTHROUGH RECOVERY GROUP, INC.
Entity Type:Organization
Organization Name:BREAKTHROUGH RECOVERY GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:F
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:CDP
Authorized Official - Phone:509-927-6838
Mailing Address - Street 1:11711 E SPRAGUE AVE
Mailing Address - Street 2:SUITE D4
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-6126
Mailing Address - Country:US
Mailing Address - Phone:509-927-6838
Mailing Address - Fax:509-927-6845
Practice Address - Street 1:11711 E SPRAGUE AVE
Practice Address - Street 2:SUITE D4
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-6126
Practice Address - Country:US
Practice Address - Phone:509-927-6838
Practice Address - Fax:509-927-6845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-14
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA32160200251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health