Organization
BREAKTHROUGH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOANN H. LONG BS, RN (EXECUTIVE DIRECTOR)
(919) 493-2791
Entity
Organization
Contact information
Practice address
6 CONSULTANT PL, SUITE 100, DURHAM, NC 27707-3598
(919) 493-2791
(919) 493-4342
Mailing address
PO BOX 52660, DURHAM, NC 27717-2660
(919) 493-2791
(919) 493-4342
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005723
—
NC
05
—
8301002
—
NC
05
—
8301002B
—
NC
05
—
8301002P
—
NC
05
—
8301002Q
—
NC
Enumeration date
06/20/2007
Last updated
08/22/2020
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