Provider Demographics
NPI:1871792150
Name:BUILDING PEOPLE BUILDING COMMUNITY INC
Entity type:Organization
Organization Name:BUILDING PEOPLE BUILDING COMMUNITY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF ORGANIZATION
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:KARL
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:DM
Authorized Official - Phone:317-920-1300
Mailing Address - Street 1:3549 BOULEVARD PL
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-4403
Mailing Address - Country:US
Mailing Address - Phone:317-920-1300
Mailing Address - Fax:
Practice Address - Street 1:3549 BOULEVARD PL
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-4403
Practice Address - Country:US
Practice Address - Phone:317-920-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-16
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 104100000X, 172V00000X, 246QL0901X
IN28041546A163W00000X
IN01061519A207Q00000X
IN01030481A207V00000X
IN10000107A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No246QL0901XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyLaboratory Management, DiplomateGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200886780AMedicaid
IN200886780AMedicaid