Provider Demographics
NPI:1609285634
Name:BREAKTHROUGH FAMILY SERVICES
Entity Type:Organization
Organization Name:BREAKTHROUGH FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBRELLE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-572-1068
Mailing Address - Street 1:1000 WINTER ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39204-2849
Mailing Address - Country:US
Mailing Address - Phone:601-592-7060
Mailing Address - Fax:
Practice Address - Street 1:1000 WINTER ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39204-2849
Practice Address - Country:US
Practice Address - Phone:601-592-7060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-04
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management