Provider Demographics
NPI:1164168787
Name:BREAKING BARRIERS UTAH
Entity Type:Organization
Organization Name:BREAKING BARRIERS UTAH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARQUITA
Authorized Official - Middle Name:VALDEZ
Authorized Official - Last Name:CRUZE
Authorized Official - Suffix:
Authorized Official - Credentials:PEER SUPPORT
Authorized Official - Phone:801-634-6918
Mailing Address - Street 1:1101 S OREM BLVD
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-6931
Mailing Address - Country:US
Mailing Address - Phone:385-349-5055
Mailing Address - Fax:
Practice Address - Street 1:1101 S OREM BLVD
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-6931
Practice Address - Country:US
Practice Address - Phone:385-349-5055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)