| NPI | 1952682247 |
|---|---|
| Former Legal Business Name | BREAKTHROUGH REVIVAL CENTER CHURCH, INC. |
| Entity Type | Organization |
| Authorized Contact | LYDIA K JONES Administrator 252-985-1875 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2011-08-31 |