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General NPI Number Information
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NPI Number | 1265953194
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Entity Type | Organization
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Legal Business Name | BUILDING BLOCK, LLC
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Dates
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Enumeration Date | 06/30/2017
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Last Update Date | 06/30/2017
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Provider Practice Location Address
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Address Line | 554 N MAIN ST STE 103
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City | SOUTH BOSTON
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State | VA
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Zip | 24592-3283
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Country | US
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Telephone | 434-226-0204
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1543
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City | SOUTH BOSTON
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State | VA
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Zip | 24592-1543
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. AMY MCMASTERS-YORK
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Credential |
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Telephone | 434-226-0204
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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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