| Built For Growth Llc | |
|
84 Front St Ste A Port Jervis NY 12771-2415 | |
| (718) 913-0234 | |
| Not Available |
| Full Name | Built For Growth Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 84 Front St Ste A, Port Jervis, New York |
| Authorized Official Name and Position | Marcela Blair (OWNER) |
| Authorized Official Contact | 7189130234 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Built For Growth Llc 84 Front St Ste A Port Jervis NY 12771-2415 Ph: (718) 913-0234 | Built For Growth Llc 84 Front St Ste A Port Jervis NY 12771-2415 Ph: (718) 913-0234 |
| NPI Number | 1790495364 |
|---|---|
| Provider Enumeration Date | 12/05/2022 |
| Last Update Date | 12/05/2022 |
| Certification Date | 07/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790495364 | NPI | - | NPPES |
| 757683 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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