Provider Demographics
NPI:1073108361
Name:BREAKTHROUGH IN HOME SERVICE IHS INC.
Entity Type:Organization
Organization Name:BREAKTHROUGH IN HOME SERVICE IHS INC.
Other - Org Name:BREAKTHROUGH IN HOME SERVICE IHS INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:REID-WALLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-400-8471
Mailing Address - Street 1:10630 LANDSEER DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-4548
Mailing Address - Country:US
Mailing Address - Phone:314-400-8471
Mailing Address - Fax:314-656-1551
Practice Address - Street 1:7220 N LINDBERGH BLVD STE 370
Practice Address - Street 2:
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-2019
Practice Address - Country:US
Practice Address - Phone:314-400-8471
Practice Address - Fax:314-656-1551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-08
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty