Provider Demographics
NPI:1003642034
Name:BREAKING ALL BARRIERS
Entity type:Organization
Organization Name:BREAKING ALL BARRIERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERELL
Authorized Official - Middle Name:
Authorized Official - Last Name:BENDERS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, ED
Authorized Official - Phone:973-819-2033
Mailing Address - Street 1:23 WHEELER ST
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-4603
Mailing Address - Country:US
Mailing Address - Phone:973-819-2033
Mailing Address - Fax:
Practice Address - Street 1:23 WHEELER ST
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-4603
Practice Address - Country:US
Practice Address - Phone:973-819-2033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service