Organization
CASTLE HOME MODIFICATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA CASTLE (MEMBER)
(419) 749-2022
Entity
Organization
Contact information
Practice address
102 S MAIN ST, CONVOY, OH 45832-7710
(419) 749-2022
(419) 749-2022
Mailing address
PO BOX 38, 102 S. MAIN ST., CONVOY, OH 45832-0038
(419) 749-2022
(419) 749-2022
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0100374
—
OH
Enumeration date
01/14/2016
Last updated
01/14/2016
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