| NPI | 1265061279 |
|---|---|
| Doing Business As | PROVIDENCE BREAKTHROUGH |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary Of Enrollments 425-358-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2025-05-14 |