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NPI Code Detail

MEDICARE: BUILDING BLOCKS COUNSELING,LLC

MEDICARE: BUILDING BLOCKS COUNSELING,LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1760953475
Entity Type Code : Organization
Provider Name (Legal Business Name) : BUILDING BLOCKS COUNSELING,LLC
Provider Business Mailing Address
First Line : PO BOX 44701
Second Line :
City : PHOENIX
State : AZ
Zip : 85064-4701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2451 E BASELINE RD STE 430
Second Line :
City : GILBERT
State : AZ
Zip : 85234-2473
Country : US
Telephone Number : 602-626-8112
Fax Number :
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : VERN JOHNSON
Credential :
Telephone Number : 602-626-8112
Provider Enumeration Date : 12/07/2018
Last Update Date : 12/07/2018

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Directions to “BUILDING BLOCKS COUNSELING,LLC ” Practice Location

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