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General NPI Number Information
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NPI Number | 1326600792
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Entity Type | Organization
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Legal Business Name | BUILDING BLOCKS HEALTHCARE NETWORK LLC
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Dates
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Enumeration Date | 07/05/2019
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Last Update Date | 07/12/2022
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Provider Practice Location Address
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Address Line | 3242 ESTHER PL
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City | BALTIMORE
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State | MD
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Zip | 21224-1431
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Country | US
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Telephone | 410-725-1435
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Fax |
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Provider Business Mailing Address
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Address Line | 13603 MARY BOWIE PKWY
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City | UPPER MARLBORO
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State | MD
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Zip | 20774-9075
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Country | US
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Telephone | 443-651-4019
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTY TERESA GODWIN
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Credential |
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Telephone | 443-651-4019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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Taxonomy #10
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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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