=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700720240
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BUILD YOUTH PROJECT LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/15/2026
-----------------------------------------------------
Last Update Date | 04/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2178 BRIDLEWOOD BLVD
-----------------------------------------------------
City | OBETZ
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43207-5203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-806-3211
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2105 S HAMILTON RD
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43232-4145
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-806-3211
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/FOUNDER
-----------------------------------------------------
Name | MECHELLE R DARBY
-----------------------------------------------------
Credential | QMHS/CDCA
-----------------------------------------------------
Telephone | 614-806-3211
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------