Organization
BROKEN BY VIOLENCE
Active
Other names
Broken By Violence
Organization subpart
No
Provider details
NPI number
Authorized official
EBONY ANTOINE (EXCEUTIVE DIRECTOR)
(209) 688-4614
Entity
Organization
Contact information
Practice address
840 E TRAVIS BLVD APT 308, FAIRFIELD, CA 94533-5323
(209) 688-4614
Mailing address
840 E TRAVIS BLVD APT 308, FAIRFIELD, CA 94533-5323
(209) 688-4614
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/13/2025
Last updated
02/13/2025
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