Provider Demographics
NPI:1245047125
Name:BUILDING BRIDGES LLC
Entity type:Organization
Organization Name:BUILDING BRIDGES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/RMHCI
Authorized Official - Prefix:
Authorized Official - First Name:DARYEL
Authorized Official - Middle Name:LORENZO
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-472-2500
Mailing Address - Street 1:3270 SUNTREE BLVD FL USA 3270
Mailing Address - Street 2:1113 C
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7530
Mailing Address - Country:US
Mailing Address - Phone:321-472-2500
Mailing Address - Fax:
Practice Address - Street 1:3270 SUNTREE BLVD FL USA 3270
Practice Address - Street 2:1113 C
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7530
Practice Address - Country:US
Practice Address - Phone:321-472-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-14
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251S00000XAgenciesCommunity/Behavioral Health