MEDICARE: BUILDING BLOCKS COMPREHENSIVE SERVICES, INC.

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
1	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1841439528
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUILDING BLOCKS COMPREHENSIVE SERVICES, INC.

Provider Business Mailing Address
First Line	:	275 PARRISH ST
Second Line	:	SUITE A
City	:	CANANDAIGUA
State	:	NY
Zip	:	14424-1785
Country	:	US
Telephone Number	:	585-393-0554
Fax Number	:	585-393-0676

Provider Business Practice Location Address
First Line	:	275 PARRISH ST
Second Line	:	SUITE A
City	:	CANANDAIGUA
State	:	NY
Zip	:	14424-1785
Country	:	US
Telephone Number	:	585-393-0554
Fax Number	:	585-393-0676

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. KELLY G BATEMAN
Credential	:	MSED, OTR/L
Telephone Number	:	585-393-0554

Provider Enumeration Date	:	02/19/2009
Last Update Date	:	02/19/2009

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