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 ST, AURORA, IL 60506-5084
(630) 897-1003
(630) 897-1042
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
A-0380-0002-A
IL
Other
Enumeration date
04/04/2017
Last updated
04/04/2017
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