Provider Demographics
NPI:1972132231
Name:BUILDING BLOCKS COUNSELING,LLC
Entity Type:Organization
Organization Name:BUILDING BLOCKS COUNSELING,LLC
Other - Org Name:AXIOM CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VERN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-626-8112
Mailing Address - Street 1:7725 N 43RD AVE STE 522
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-5771
Mailing Address - Country:US
Mailing Address - Phone:602-626-8112
Mailing Address - Fax:602-612-6910
Practice Address - Street 1:150 N OCOTILLO DR BLDG 1
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85120-3740
Practice Address - Country:US
Practice Address - Phone:602-626-8112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-07
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility