Provider Demographics
NPI:1154844223
Name:BUILDING BLOCKS EKY, LLC
Entity Type:Organization
Organization Name:BUILDING BLOCKS EKY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-547-1070
Mailing Address - Street 1:2414 BLACKBURN AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-4734
Mailing Address - Country:US
Mailing Address - Phone:606-210-1571
Mailing Address - Fax:
Practice Address - Street 1:2414 BLACKBURN AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-4734
Practice Address - Country:US
Practice Address - Phone:606-210-1571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYVZ3VT5HC4OtherDEVELOPMENTAL INTERVENTION PROVIDER
KYVZ3VT5HC4Medicaid