Organization
CUSTOM CONSTRUCTION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA JOAN MARTINEZ (EXECUTIVE DIRECTOR)
(719) 474-9988
Entity
Organization
Contact information
Practice address
5225 SODBUSTER TRL, COLORADO SPRINGS, CO 80917-1817
(719) 474-9988
Mailing address
5225 SODBUSTER TRL, COLORADO SPRINGS, CO 80917-1817
(719) 474-9988
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
22126
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22126
PIKES PEAK REGIONAL BUILDING
CO
Enumeration date
03/22/2018
Last updated
06/16/2018
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