Provider Demographics
NPI:1255964730
Name:FAMILY BUILDING BLOCKS
Entity type:Organization
Organization Name:FAMILY BUILDING BLOCKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. DIR. OF PROGRAM ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:MARGUERITE
Authorized Official - Middle Name:
Authorized Official - Last Name:KENAGY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-566-2132
Mailing Address - Street 1:2425 LANCASTER DR NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97305-1220
Mailing Address - Country:US
Mailing Address - Phone:503-566-2132
Mailing Address - Fax:
Practice Address - Street 1:2425 LANCASTER DR NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-1220
Practice Address - Country:US
Practice Address - Phone:503-566-2132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty