BREAKING FREE INC NPI 1649703018

NPI Information

  • NPI: 1649703018
  • Provider Name: BREAKING FREE INC
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Address: 120 GALE ST
    AURORA, IL
    ZIP 60506
  • Phone: (630) 897-1003

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NPI Details

BREAKING FREE INC is a mental health (including community mental health center) clinic center in Aurora, IL. BREAKING FREE INC NPI is 1649703018. The provider is registered as an organization entity type.

The provider's business location address is:

120 GALE ST
AURORA, IL
ZIP 60506-084
Phone: (630) 897-1003
Fax: (630) 897-1042

The provider's authorized official is Dimitrius R Mayo .
The authorized official title is Manager, Revenue Cycle and has the following contact phone number (630) 572-0556.

The enumeration date for this NPI number is 4/4/2017 and was last updated on 4/4/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)A-0380-0002-AILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1=========004MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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