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Organization
OPERATION BREAKTHROUGH
Active
Organization
OPERATION BREAKTHROUGH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEVERLY ARY (EXECUTIVE DIRECTOR)
(760) 365-3022
Entity
Organization
Contact information
Practice address
40880 PEDDER RD, BIG BEAR LAKE, CA 92315-6445
(909) 866-5437
(909) 866-8555
Mailing address
PO BOX 6445, BIG BEAR LAKE, CA 92315-6445
(909) 866-5437
(909) 866-8555
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
NULL
302R00000X
Health Maintenance Organization
Primary
3601501120
CA
Other
Enumeration date
08/05/2007
Last updated
07/29/2008
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