| NPI | 1306017165 |
|---|---|
| Former Legal Business Name | BREAKTHROUGH HOMES AND SERVICES |
| Entity Type | Organization |
| Authorized Contact | JACKIE CHRISTIAN BODNARIK Fiscal Director 910-347-6009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2008-06-30 |