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General NPI Number Information
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NPI Number | 1245047125
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Entity Type | Organization
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Legal Business Name | BUILDING BRIDGES LLC
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Dates
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Enumeration Date | 12/14/2024
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Last Update Date | 12/14/2024
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Provider Practice Location Address
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Address Line | 3270 SUNTREE BLVD FL USA 3270 1113 C
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City | MELBOURNE
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State | FL
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Zip | 32940-7530
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Country | US
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Telephone | 321-472-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 3270 SUNTREE BLVD FL USA 3270 1113 C
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City | MELBOURNE
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State | FL
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Zip | 32940-7530
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Country | US
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Telephone | 321-472-2500
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Fax |
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Authorized Official
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Title or Position | OWNER/RMHCI
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Name | DARYEL LORENZO SCOTT
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Credential |
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Telephone | 321-472-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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