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General NPI Number Information
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NPI Number | 1588227003
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Entity Type | Organization
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Legal Business Name | COMMUNITY RENOVATIONS INC.
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Dates
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Enumeration Date | 04/19/2019
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Last Update Date | 11/22/2022
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Provider Practice Location Address
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Address Line | 23398 GOLFVIEW DR
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City | GROSSE ILE
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State | MI
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Zip | 48138-2249
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Country | US
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Telephone | 734-732-5904
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 779
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City | GROSSE ILE
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State | MI
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Zip | 48138
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Country | US
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Telephone | 734-732-5904
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Fax | 734-795-4646
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Authorized Official
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Title or Position | OWNER
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Name | ERIC CARBAJO
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Credential |
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Telephone | 734-732-5904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number |
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License Number State |
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