Provider Demographics
NPI:1629857529
Name:BARRIERS BREAKERS EARLY INTERVENTION LLC
Entity Type:Organization
Organization Name:BARRIERS BREAKERS EARLY INTERVENTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JISSETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:PICHARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-307-1186
Mailing Address - Street 1:136 W STATE ST APT 2
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-3067
Mailing Address - Country:US
Mailing Address - Phone:347-307-1186
Mailing Address - Fax:
Practice Address - Street 1:1024 WALTON AVE APT 3A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-9320
Practice Address - Country:US
Practice Address - Phone:347-307-1186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-28
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251B00000XAgenciesCase Management