NPIMap

Organization Active NPI

Breaking Free Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Aurora, IL
National Provider Identifier
1477919405
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
BREAKING FREE INC.
Practice address
120 Gale St
Aurora, IL 60506-5084
Phone
(630) 897-1003
Fax
(630) 897-1042
NPI assigned
Jan 6, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Dimitrius R. Mayo
Title
Manager, Revenue Cycle
Phone
(630) 572-0556

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X IL
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

120 Gale St
Aurora, IL 60506-5084

Mailing address

120 Gale Street
Aurora, IL 60506-5084
Phone (630) 897-1003

National Provider Directory

National Provider Directory
Tax ID family
Breaking Free Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

120 Gale St
Aurora, IL 60506
Phone (630) 897-0084

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492041600000",
    "number": "1477919405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 GALE STREET",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605065084",
            "telephone_number": "630-897-1003",
            "fax_number": "630-897-1042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 GALE ST",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605065084",
            "telephone_number": "630-897-1003",
            "fax_number": "630-897-1042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAKING FREE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-06",
        "last_updated": "2017-04-13",
        "status": "A",
        "authorized_official_last_name": "MAYO",
        "authorized_official_first_name": "DIMITRIUS",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "MANAGER, REVENUE CYCLE",
        "authorized_official_telephone_number": "630-572-0556",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.