| Building Blocks Foundation, Inc | |
|
2922 Fuller Ave Ne Ste 107 Grand Rapids MI 49505-3459 | |
| (616) 570-0925 | |
| Not Available |
| Full Name | Building Blocks Foundation, Inc |
|---|---|
| Speciality | Speech-Language Pathologist |
| Location | 2922 Fuller Ave Ne Ste 107, Grand Rapids, Michigan |
| Authorized Official Name and Position | Courtney Sue Joesel (PRESIDENT) |
| Authorized Official Contact | 6165700925 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Building Blocks Foundation, Inc 2922 Fuller Ave Ne Ste 107 Grand Rapids MI 49505-3459 Ph: () - | Building Blocks Foundation, Inc 2922 Fuller Ave Ne Ste 107 Grand Rapids MI 49505-3459 Ph: (616) 570-0925 |
| NPI Number | 1609589589 |
|---|---|
| Provider Enumeration Date | 01/05/2023 |
| Last Update Date | 01/05/2023 |
| Certification Date | 01/05/2023 |
| Medicare PECOS PAC ID | 2769856376 |
|---|---|
| Medicare Enrollment ID | O20230322002064 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609589589 | NPI | - | NPPES |
| Provider Name | Courtney Sue Joesel |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1639584188 PECOS PAC ID: 8022234632 Enrollment ID: I20140716002273 |
| Provider Name | Sarah Joy Kidder |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1871369157 PECOS PAC ID: 0345699591 Enrollment ID: I20231213000754 |
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