Organization
BREAKING FREE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DIMITRIUS R. MAYO (MANAGER, REVENUE CYCLE)
(630) 572-0556
Entity
Organization
Contact information
Practice address
120 GALE ST, AURORA, IL 60506-5084
(630) 897-1003
(630) 897-1042
Mailing address
120 GALE STREET, AURORA, IL 60506-5084
(630) 897-1003
(630) 897-1042
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
IL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/06/2016
Last updated
04/13/2017
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