| Breakthrough Therapeutic Services Llc | |
|
1500 Market St. 12th Floor Suite 75 Philadelphia PA 19102 | |
| (856) 288-2232 | |
| Not Available |
| Full Name | Breakthrough Therapeutic Services Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1500 Market St. 12th Floor Suite 75, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | John Derrick Granger (OWNER) |
| Authorized Official Contact | 8562882232 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Breakthrough Therapeutic Services Llc 2 Logan Sq Ste 300 Philadelphia PA 19103-2733 Ph: (856) 288-2232 | Breakthrough Therapeutic Services Llc 1500 Market St. 12th Floor Suite 75 Philadelphia PA 19102 Ph: (856) 288-2232 |
| NPI Number | 1760948152 |
|---|---|
| Provider Enumeration Date | 02/11/2019 |
| Last Update Date | 01/27/2022 |
| Certification Date | 01/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760948152 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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