Provider Demographics
NPI:1548757461
Name:BREAKTHROUGH HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:BREAKTHROUGH HEALTHCARE SERVICES
Other - Org Name:BREAKTHROUGH HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:TITUS
Authorized Official - Last Name:SILLAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-885-8581
Mailing Address - Street 1:12803 GLASGOW CT
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-7034
Mailing Address - Country:US
Mailing Address - Phone:888-885-8581
Mailing Address - Fax:888-885-8581
Practice Address - Street 1:12803 GLASGOW CT
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-7034
Practice Address - Country:US
Practice Address - Phone:888-858-5818
Practice Address - Fax:888-885-8581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR4177251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health