Healthcare Provider Details

I. General information

NPI: 1710607890
Provider Name (Legal Business Name): WESTERN PEAKS GENERAL CONTRACTING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2022
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2757 MASHIE CIR
CASTLE ROCK CO
80109-3671
US

IV. Provider business mailing address

2757 MASHIE CIR
CASTLE ROCK CO
80109-3671
US

V. Phone/Fax

Practice location:
  • Phone: 303-472-4378
  • Fax:
Mailing address:
  • Phone: 303-472-4378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: MR. JEREMY ANDREW ARAGON
Title or Position: PRESIDENT
Credential:
Phone: 303-472-4378