Organization
J. R. COLEMAN COMMUNITY RENOVATION CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOM THOMPSON (EXECUTIVE DIRECTOR)
(330) 455-3873
Entity
Organization
Contact information
Practice address
1731 GRACE AVE NE, CANTON, OH 44705-2261
(330) 455-3873
(330) 455-3934
Mailing address
1731 GRACE AVE NE, CANTON, OH 44705-2261
(330) 455-3873
(330) 455-3934
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0809227
—
OH
Enumeration date
08/08/2014
Last updated
08/08/2014
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