Organization
BREAKTHROUGH COMMUNITY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLISHA JANE VANPELT (DSP)
(503) 881-6034
Entity
Organization
Contact information
Practice address
1990 SPICETREE LN SE, SALEM, OR 97306-3406
(503) 881-6034
Mailing address
1990 SPICETREE LN SE, SALEM, OR 97306-3406
(503) 881-6034
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
11/18/2022
Last updated
11/18/2022
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