Organization
BREAKTHROUGH THERAPEUTIC SUPPORTIVE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DORLA JOHNSON (CHIEF EXECUTIVE OFFICER)
(757) 353-2631
Entity
Organization
Contact information
Practice address
4400 PORTSMOUTH BLVD STE B, PORTSMOUTH, VA 23701-2542
(757) 956-6840
(855) 423-7971
Mailing address
PO BOX 9641, CHESAPEAKE, VA 23321-9641
(757) 609-8344
(855) 423-7971
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/24/2019
Last updated
12/20/2024
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