Provider Demographics
NPI:1154511921
Name:BLOCK INSTITUTE, INC.
Entity Type:Organization
Organization Name:BLOCK INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-906-5440
Mailing Address - Street 1:376 BAY 44TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-7103
Mailing Address - Country:US
Mailing Address - Phone:718-906-5400
Mailing Address - Fax:
Practice Address - Street 1:3094 BRIGHTON 5TH ST
Practice Address - Street 2:APT. E3
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7041
Practice Address - Country:US
Practice Address - Phone:718-646-2940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7455449320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities