Organization
BREAKTHROUGH
Active
Other names
Breakthrough
Organization subpart
No
Provider details
NPI number
Authorized official
SUKIMO D KNIGHT LADC (EXECUTIVE DIRECTOR)
(612) 201-8111
Entity
Organization
Contact information
Practice address
2147 UNIVERSITY AVE W, SAINT PAUL, MN 55114-1313
(651) 340-6795
(651) 202-3166
Mailing address
2147 UNIVERSITY AVE W, SAINT PAUL, MN 55114-1313
(651) 340-6795
(651) 202-3166
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
08/06/2020
Last updated
08/06/2020
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