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General NPI Number Information
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NPI Number | 1477793990
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Entity Type | Organization
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Legal Business Name | BUILDING BRIDGES PA, LLC
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Dates
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Enumeration Date | 02/23/2009
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Last Update Date | 02/23/2009
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Provider Practice Location Address
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Address Line | 201 WOOLSTON DR SUITE #2C
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City | MORRISVILLE
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State | PA
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Zip | 19067-5008
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Country | US
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Telephone | 215-740-4201
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Fax |
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Provider Business Mailing Address
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Address Line | 201 WOOLSTON DR SUITE #2C
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City | MORRISVILLE
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State | PA
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Zip | 19067-5008
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Country | US
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Telephone | 215-740-4201
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JENNIFER R FREEMAN
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Credential | LSW
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Telephone | 215-740-4201
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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 | SW012568L
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License Number State | PA
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