Healthcare Provider Details

I. General information

NPI: 1750894309
Provider Name (Legal Business Name): BUILDING ESSENTIAL SKILLS TOGETHER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2017
Last Update Date: 07/13/2023
Certification Date: 07/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 TREBLE COVE RD
NORTH BILLERICA MA
01862-2231
US

IV. Provider business mailing address

100 TREBLE COVE RD
NORTH BILLERICA MA
01862-2231
US

V. Phone/Fax

Practice location:
  • Phone: 508-233-2308
  • Fax:
Mailing address:
  • Phone: 508-233-2308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: REBECCA SANTOS
Title or Position: CO-OWNER
Credential: BCBA, LABA
Phone: 781-831-2853