Provider Demographics
NPI:1255878716
Name:BREAKING CHANGE SERVICES
Entity type:Organization
Organization Name:BREAKING CHANGE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:CHERYLOU
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-844-0431
Mailing Address - Street 1:260 S CYPRESS WAY
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-3812
Mailing Address - Country:US
Mailing Address - Phone:407-844-0431
Mailing Address - Fax:
Practice Address - Street 1:260 S CYPRESS WAY
Practice Address - Street 2:
Practice Address - City:CASSLEBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707
Practice Address - Country:US
Practice Address - Phone:407-844-0431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care