# COLMAN LIFE BREAKTHROUGH LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** COLMAN LIFE BREAKTHROUGH LLC
- **Other names:** Colman Life Breakthrough LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1093369472
- **Legal business name:** COLMAN LIFE BREAKTHROUGH LLC
- **Authorized official:** MRS. LERREA MADELEINE MENGATA LPN (INDEPENDENT NURSE)
- **Authorized official phone:** (857) 249-8804

## Contact information

- **Practice address:** 227 FOSTER RD, TEWKSBURY, MA 01876-2809
- **Practice address phone:** (857) 249-8804
- **Mailing address:** 227 FOSTER RD, TEWKSBURY, MA 01876-2809
- **Mailing address phone:** (857) 249-8804

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 164W00000X | Licensed Practical Nurse | — | NULL | — |
| 164W00000X | Licensed Practical Nurse | — | — | — |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 07/24/2019
- **Last updated:** 03/01/2021