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General NPI Number Information
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NPI Number | 1780997460
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Entity Type | Organization
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Legal Business Name | BUILDING TO LIFE INC.
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Dates
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Enumeration Date | 07/22/2010
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Last Update Date | 07/22/2010
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Provider Practice Location Address
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Address Line | 4728 OXFORD AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19124-5835
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Country | US
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Telephone | 215-391-8921
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Fax |
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Provider Business Mailing Address
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Address Line | 7419 BARCLAY RD
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City | CHELTENHAM
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State | PA
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Zip | 19012-1302
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Country | US
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Telephone | 215-281-8458
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Fax |
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Authorized Official
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Title or Position | PRORAM DIRECTOR
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Name | WALTER E DAVIS
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Credential | BS/IJJDP/ICCJP
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Telephone | 215-281-8458
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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 | 30054
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 30054
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License Number State | PA
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