Organization
HOME MASTER GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BJ VANCLEAVE (CEO)
(731) 613-9107
Entity
Organization
Contact information
Practice address
2052 RHINO CROSSING, MILAN, TN 38358
(731) 506-4600
Mailing address
PO BOX 618, MILAN, TN 38358-0618
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
00065152
TN
Other
Enumeration date
02/28/2012
Last updated
02/28/2012
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