Provider Demographics
NPI:1093542201
Name:BREAKTHROUGH HEALTHCARE LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:BREAKTHROUGH HEALTHCARE LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNERS
Authorized Official - Prefix:
Authorized Official - First Name:SHANEKIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDSAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-649-5586
Mailing Address - Street 1:612 OAK HILL DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62223-2259
Mailing Address - Country:US
Mailing Address - Phone:618-580-4253
Mailing Address - Fax:
Practice Address - Street 1:677 CRAIG RD STE 204
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-7125
Practice Address - Country:US
Practice Address - Phone:314-649-5586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BREAKTHROUGH HEALTHCARE LIMITED LIABILITY COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health