Provider Demographics
NPI:1275292096
Name:BREAKTHROUGH THERAPEUTICS
Entity Type:Organization
Organization Name:BREAKTHROUGH THERAPEUTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:BILLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOURDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-869-1208
Mailing Address - Street 1:7750 OKEECHOBEE BLVD STE 4-1032
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-2104
Mailing Address - Country:US
Mailing Address - Phone:561-247-5550
Mailing Address - Fax:
Practice Address - Street 1:7750 OKEECHOBEE BLVD STE 4-1032
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-2104
Practice Address - Country:US
Practice Address - Phone:561-247-5550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-08
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health