Provider Demographics
NPI:1114631918
Name:BREAKTHROUGH HOMES LLC
Entity Type:Organization
Organization Name:BREAKTHROUGH HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:MARTINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KINCHION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-727-9103
Mailing Address - Street 1:1200 S 10TH ST UNIT 703
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-2636
Mailing Address - Country:US
Mailing Address - Phone:316-727-9103
Mailing Address - Fax:
Practice Address - Street 1:1200 S 10TH ST UNIT 703
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-2636
Practice Address - Country:US
Practice Address - Phone:316-727-9103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities