Provider Demographics
NPI:1881333672
Name:COMMUNITY BUILDERSA
Entity type:Organization
Organization Name:COMMUNITY BUILDERSA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALKARRIEM
Authorized Official - Middle Name:
Authorized Official - Last Name:MUHAMMAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-706-5656
Mailing Address - Street 1:1626 N 7TH ST, PHOENIX, AZ, 85006, USA
Mailing Address - Street 2:1626 N 7TH ST
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006
Mailing Address - Country:US
Mailing Address - Phone:702-706-5656
Mailing Address - Fax:
Practice Address - Street 1:1626 N 7TH ST, PHOENIX, AZ, 85006, USA
Practice Address - Street 2:1626 N 7TH ST
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006
Practice Address - Country:US
Practice Address - Phone:702-706-5656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-01
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty