Organization Active NPI

Breakthrough

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Saint Paul, MN
National Provider Identifier
1205446044
Registry record updated Aug 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
BREAKTHROUGH
Practice address
2147 University Ave W
Saint Paul, MN 55114-1313
Phone
(651) 340-6795
Fax
(651) 202-3166
NPI assigned
Aug 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sukimo D Knight, LADCNPI 1225671415
Title
Executive Director
Phone
(612) 201-8111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

2147 University Ave W
Saint Paul, MN 55114-1313

Mailing address

2147 University Ave W
Saint Paul, MN 55114-1313
Phone (651) 340-6795

Other names 1

  • Breakthrough Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596672000000",
    "number": "1205446044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2147 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141313",
            "telephone_number": "651-340-6795",
            "fax_number": "651-202-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2147 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141313",
            "telephone_number": "651-340-6795",
            "fax_number": "651-202-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAKTHROUGH",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-06",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A",
        "authorized_official_last_name": "KNIGHT",
        "authorized_official_first_name": "SUKIMO",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "612-201-8111",
        "authorized_official_credential": "LADC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Breakthrough",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.