BLOCKDARE INC


Address: 2260 Brentford Rd, San Marino, CA 91108-2801
Phone: 6264293651

BLOCKDARE INC (NPI# 1205241163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1205241163
Entity Type Organization
Organization Name BLOCKDARE INC
Practice Address 2260 Brentford Rd
San Marino
CA 91108-2801
Practice Telephone 6264293651
Mailing Telephone 6264293651
Enumeration Date 2014-06-29
Last Update Date 2014-06-29
Authorized Official Name DR. STELLA M ABRAHAN (SUPERVISOR)
Authorized Official Telephone 6264293651
Authorized Official Credential PHD,MFT
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM0855X Clinic/Center
Specialization: Adolescent and Children Mental Health
0M15046 CA Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
CA NONE M015046 01

Office Location

Street Address 2260 BRENTFORD RD
City SAN MARINO
State CA
Zip Code 91108-2801

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Taxonomy Information

Taxonomy Code 261QM0855X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Adolescent and Children Mental Health

Taxonomy Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
Notes: [7/1/2003: new]

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Competitor

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City SAN MARINO
Zip Code 91108

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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