Organization
BREAKTHROUGH OUTBREAKING OUTREACH MINISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALDARRIS ELLIOTT (OWNER AND PRESIDENT)
(910) 748-6991
Entity
Organization
Contact information
Practice address
7653 BRANCHWOOD CIR, FAYETTEVILLE, NC 28314-5801
(910) 748-6991
Mailing address
7653 BRANCHWOOD CIR, FAYETTEVILLE, NC 28314-5801
(910) 748-6991
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
175T00000X
Peer Specialist
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NA
—
NC
Enumeration date
02/17/2021
Last updated
02/22/2021
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