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NPI Code Detail

MEDICARE: FAMILY BUILDING BLOCKS

MEDICARE: FAMILY BUILDING BLOCKS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1255964730
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY BUILDING BLOCKS
Provider Business Mailing Address
First Line : 2425 LANCASTER DR NE
Second Line :
City : SALEM
State : OR
Zip : 97305-1220
Country : US
Telephone Number : 503-566-2132
Fax Number :
Provider Business Practice Location Address
First Line : 2425 LANCASTER DR NE
Second Line :
City : SALEM
State : OR
Zip : 97305-1220
Country : US
Telephone Number : 503-566-2132
Fax Number :
Authorized Official
Title or Position : PROGRAM DIRECTOR
Name : BENJAMIN FENNIMORE
Credential : LCSW
Telephone Number : 503-566-2132
Provider Enumeration Date : 02/12/2020
Last Update Date : 02/03/2026

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Directions to “FAMILY BUILDING BLOCKS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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