Provider Demographics
NPI:1710075916
Name:BUILDING MOMENTUM INC.
Entity Type:Organization
Organization Name:BUILDING MOMENTUM INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:SIDBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:954-382-4889
Mailing Address - Street 1:300 S PINE ISLAND RD
Mailing Address - Street 2:SUITE 227
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2673
Mailing Address - Country:US
Mailing Address - Phone:954-382-4889
Mailing Address - Fax:954-382-4884
Practice Address - Street 1:300 S PINE ISLAND RD
Practice Address - Street 2:SUITE 227
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2673
Practice Address - Country:US
Practice Address - Phone:954-382-4889
Practice Address - Fax:954-382-4884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 6164103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQ0314Medicare PIN