Provider Demographics
NPI:1932701828
Name:BREAKTHROUGH MENTAL HEALTHCARE LLC
Entity Type:Organization
Organization Name:BREAKTHROUGH MENTAL HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:TONIA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:AJAMU
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:214-223-8150
Mailing Address - Street 1:17304 PRESTON RD STE 800
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5645
Mailing Address - Country:US
Mailing Address - Phone:214-223-8150
Mailing Address - Fax:214-975-2935
Practice Address - Street 1:6136 FRISCO SQUARE BLVD STE 400
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-3251
Practice Address - Country:US
Practice Address - Phone:469-287-5505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-15
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)