Organization
BREAKTHROUGH MENTAL HEALTH AND WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHEYENNE COOPER (CEO)
(240) 650-5769
Entity
Organization
Contact information
Practice address
7310 RITCHIE HWY STE 200, GLEN BURNIE, MD 21061-3065
(240) 650-5769
Mailing address
7310 RITCHIE HWY STE 200, GLEN BURNIE, MD 21061-3065
(240) 650-5769
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
310500000X
Mental Illness Intermediate Care Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
03/04/2024
Last updated
03/05/2024
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