Provider Demographics
NPI:1528513538
Name:BUILDING A STRONG FOUNDATION CONSULTANT SERVICE LLC
Entity type:Organization
Organization Name:BUILDING A STRONG FOUNDATION CONSULTANT SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:MED, MS
Authorized Official - Phone:301-800-4647
Mailing Address - Street 1:2014 PLANTATION KEY CIR
Mailing Address - Street 2:104
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-4697
Mailing Address - Country:US
Mailing Address - Phone:301-800-4647
Mailing Address - Fax:
Practice Address - Street 1:7301 HOWARD CIR
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-1940
Practice Address - Country:US
Practice Address - Phone:301-800-4647
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-19
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health