| Breakthrough Transitions Llc | |
|
2110 N Donnelly St Ste 500 Mount Dora FL 32757-6968 | |
| (321) 362-4176 | |
| (321) 297-5003 |
| Full Name | Breakthrough Transitions Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2110 N Donnelly St Ste 500, Mount Dora, Florida |
| Authorized Official Name and Position | Stephanie A Mcshan (OWNER) |
| Authorized Official Contact | 4076161530 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Breakthrough Transitions Llc Po Box 639 Plymouth FL 32768 Ph: (407) 616-1530 | Breakthrough Transitions Llc 2110 N Donnelly St Ste 500 Mount Dora FL 32757-6968 Ph: (321) 362-4176 |
| NPI Number | 1902274624 |
|---|---|
| Provider Enumeration Date | 09/11/2015 |
| Last Update Date | 01/26/2022 |
| Certification Date | 01/26/2022 |
| Medicare PECOS PAC ID | 1759798796 |
|---|---|
| Medicare Enrollment ID | O20210318001640 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902274624 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Stephanie Albertha Mcshan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942550033 PECOS PAC ID: 0143577106 Enrollment ID: I20190227001896 |
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