| Breakthrough Services Llc | |
|
12821 Newport Ave Tustin CA 92780 | |
| (562) 264-5917 | |
| (714) 333-4848 |
| Full Name | Breakthrough Services Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 12821 Newport Ave, Tustin, California |
| Authorized Official Name and Position | Tetia Terez Henson (OWNER) |
| Authorized Official Contact | 5622645917 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Breakthrough Services Llc 12821 Newport Ave Tustin CA 92780 Ph: (562) 264-5917 | Breakthrough Services Llc 12821 Newport Ave Tustin CA 92780 Ph: (562) 264-5917 |
| NPI Number | 1598374118 |
|---|---|
| Provider Enumeration Date | 07/29/2020 |
| Last Update Date | 07/29/2020 |
| Certification Date | 07/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598374118 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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