Healthcare Provider Details

I. General information

NPI: 1750211272
Provider Name (Legal Business Name): BREAKTHROUGH HOME CARE SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 S LAKE ST # D2
GARY IN
46403-2396
US

IV. Provider business mailing address

607 S LAKE ST # D2
GARY IN
46403-2396
US

V. Phone/Fax

Practice location:
  • Phone: 219-713-5125
  • Fax: 219-841-7589
Mailing address:
  • Phone: 219-713-5125
  • Fax: 219-841-7589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. DANIELLE LATRICE JOHNSON
Title or Position: OWNER
Credential:
Phone: 219-713-5125