Provider Demographics
NPI:1225043763
Name:BUILD FELLOWSHIP, INC.
Entity Type:Organization
Organization Name:BUILD FELLOWSHIP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRPERSON
Authorized Official - Prefix:
Authorized Official - First Name:SYLVESTER
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-528-0305
Mailing Address - Street 1:2114 N CHARLES ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-5765
Mailing Address - Country:US
Mailing Address - Phone:410-528-0305
Mailing Address - Fax:410-528-0316
Practice Address - Street 1:2114 N CHARLES ST
Practice Address - Street 2:SUITE 100
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-5765
Practice Address - Country:US
Practice Address - Phone:410-528-0305
Practice Address - Fax:410-528-0316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility