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General NPI Number Information
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NPI Number | 1164419990
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Entity Type | Organization
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Legal Business Name | BUILDING BLOCKS PEDIATRIC HOME HEALTH SERVICES
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 05/19/2011
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Provider Practice Location Address
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Address Line | 6 JOURNEY SUITES 135
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City | ALISO VIEJO
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State | CA
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Zip | 92656-5317
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Country | US
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Telephone | 813-890-8004
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Fax | 813-290-9691
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Provider Business Mailing Address
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Address Line | PO BOX 779
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City | COLUMBIA
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State | SC
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Zip | 29202-0779
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Country | US
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Telephone | 813-890-8004
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Fax | 813-290-9691
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Authorized Official
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Title or Position | PRESIDENT
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Name | RON MILLS
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Credential |
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Telephone | 813-890-8004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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