Provider Demographics
NPI:1396881108
Name:BREAKTHROUGH CORPORATION
Entity type:Organization
Organization Name:BREAKTHROUGH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:RITCHIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-247-0065
Mailing Address - Street 1:900 EAST HILL AVE, SUITE 145
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37915
Mailing Address - Country:US
Mailing Address - Phone:865-247-0065
Mailing Address - Fax:865-247-0066
Practice Address - Street 1:900 EAST HILL AVE, SUITE 145
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37915
Practice Address - Country:US
Practice Address - Phone:865-247-0065
Practice Address - Fax:865-247-0066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNL3(32)4M30171727251C00000X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN00E49OtherMR SERVICES NUMBER