Provider Demographics
NPI:1316580897
Name:BREAKING FREE INC
Entity Type:Organization
Organization Name:BREAKING FREE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:STRICKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:630-897-1003
Mailing Address - Street 1:120 GALE ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-5084
Mailing Address - Country:US
Mailing Address - Phone:630-897-1003
Mailing Address - Fax:630-897-1042
Practice Address - Street 1:1329 N LAKE ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-2409
Practice Address - Country:US
Practice Address - Phone:630-897-1003
Practice Address - Fax:630-897-1042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health