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NPI Code Detail

MEDICARE: BREAKTHROUGH HEALTHCARE LIMITED LIABILITY COMPANY

MEDICARE: BREAKTHROUGH HEALTHCARE LIMITED LIABILITY COMPANY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency
2261QA0600XAdult Day Care Clinic/Center
3253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1093542201
Entity Type Code : Organization
Provider Name (Legal Business Name) : BREAKTHROUGH HEALTHCARE LIMITED LIABILITY COMPANY
Provider Business Mailing Address
First Line : 11862 LACKLAND RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63146-4206
Country : US
Telephone Number : 314-649-5586
Fax Number : 866-203-2364
Provider Business Practice Location Address
First Line : 11862 LACKLAND RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63146-4206
Country : US
Telephone Number : 314-649-5586
Fax Number : 866-203-2364
Authorized Official
Title or Position : OWNER
Name : SHANEKIA LINDSAY
Credential :
Telephone Number : 314-649-5586
Provider Enumeration Date : 09/19/2024
Last Update Date : 12/12/2025

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Directions to “BREAKTHROUGH HEALTHCARE LIMITED LIABILITY COMPANY ” Practice Location

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