Provider Demographics
NPI:1700054681
Name:BREAKTHROUGH COUNSELING CENTER
Entity Type:Organization
Organization Name:BREAKTHROUGH COUNSELING CENTER
Other - Org Name:BREAKTHROUGH MEDIATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:AMIOHI
Authorized Official - Last Name:UWADIA AJOKU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-397-4200
Mailing Address - Street 1:324 N PARK AVE
Mailing Address - Street 2:PO BOX 331
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91768-3839
Mailing Address - Country:US
Mailing Address - Phone:909-397-4200
Mailing Address - Fax:909-397-4227
Practice Address - Street 1:324 N PARK AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91768-3839
Practice Address - Country:US
Practice Address - Phone:909-397-4200
Practice Address - Fax:909-397-4227
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BREAKTHROUGH CONSULTING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty