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General NPI Number Information
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NPI Number | 1700111234
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Entity Type | Organization
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Legal Business Name | BUILDING BLOCKS COMPREHENSIVE SERVICES,INC
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Dates
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Enumeration Date | 10/16/2009
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Last Update Date | 10/16/2009
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Provider Practice Location Address
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Address Line | 275 PARRISH ST
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City | CANANDAIGUA
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State | NY
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Zip | 14424-1785
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Country | US
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Telephone | 565-393-0554
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Fax |
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Provider Business Mailing Address
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Address Line | 59 W 5TH STREET RD
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City | OSWEGO
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State | NY
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Zip | 13126-6575
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Country | US
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Telephone | 315-216-6198
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Fax |
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Authorized Official
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Title or Position | OWNER OF BUILDING BLOCKS
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Name | KELLY BATEMAN
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Credential | MSED,OTR/L
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Telephone | 585-393-0554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 002293-1
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License Number State | NY
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