Provider Demographics
NPI:1598917569
Name:BUILDING BLOCKS DEVELOPMENTAL PRE-SCHOOL
Entity Type:Organization
Organization Name:BUILDING BLOCKS DEVELOPMENTAL PRE-SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:CHARBONNEAU
Authorized Official - Suffix:
Authorized Official - Credentials:MA,PD
Authorized Official - Phone:631-499-1237
Mailing Address - Street 1:29 PINEWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725
Mailing Address - Country:US
Mailing Address - Phone:631-499-1237
Mailing Address - Fax:
Practice Address - Street 1:29 PINEWOOD DR
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-5612
Practice Address - Country:US
Practice Address - Phone:631-499-1237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency