Provider Demographics
NPI:1003192824
Name:BUILDING A SOLID FOUNDATION
Entity Type:Organization
Organization Name:BUILDING A SOLID FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD EDD
Authorized Official - Phone:770-469-3211
Mailing Address - Street 1:961 N HAIRSTON RD
Mailing Address - Street 2:230A
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-2854
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:961 N HAIRSTON RD
Practice Address - Street 2:230A
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-2854
Practice Address - Country:US
Practice Address - Phone:770-469-3211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA053985334OtherDRIVER LICENSE