Provider Demographics
NPI:1871781211
Name:BREAK THRU MINISTRIES
Entity type:Organization
Organization Name:BREAK THRU MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWK
Authorized Official - Suffix:
Authorized Official - Credentials:MFT, REVEREND
Authorized Official - Phone:714-828-0127
Mailing Address - Street 1:3552 GREEN AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3243
Mailing Address - Country:US
Mailing Address - Phone:562-431-1799
Mailing Address - Fax:562-799-9219
Practice Address - Street 1:3552 GREEN AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3243
Practice Address - Country:US
Practice Address - Phone:562-431-1799
Practice Address - Fax:562-799-9219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC34851251S00000X
CAMFC 20752251S00000X
CAMFC43015251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health