| Breakthrough Clinical Services | |
|
360 Bloomfield Ave Ste 301 Windsor CT 06095-2700 | |
| (860) 597-7504 | |
| Not Available |
| Full Name | Breakthrough Clinical Services |
|---|---|
| Speciality | Social Worker |
| Location | 360 Bloomfield Ave, Windsor, Connecticut |
| Authorized Official Name and Position | Velanda Samuel (OWNER) |
| Authorized Official Contact | 8605977504 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Breakthrough Clinical Services 72 Briarwood Dr Windsor CT 06095-3937 Ph: (860) 597-7504 | Breakthrough Clinical Services 360 Bloomfield Ave Ste 301 Windsor CT 06095-2700 Ph: (860) 597-7504 |
| NPI Number | 1871982967 |
|---|---|
| Provider Enumeration Date | 01/13/2015 |
| Last Update Date | 03/03/2017 |
| Medicare PECOS PAC ID | 4587949276 |
|---|---|
| Medicare Enrollment ID | O20170320002392 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871982967 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 008665 (Connecticut) | Primary |
| Provider Name | Velanda Maria Samuel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588055818 PECOS PAC ID: 8022393719 Enrollment ID: I20170320002532 |
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