Provider Demographics
NPI:1386889459
Name:TOP NOTCH CONSTRUCTION
Entity type:Organization
Organization Name:TOP NOTCH CONSTRUCTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:S
Authorized Official - Last Name:VICKERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-671-0771
Mailing Address - Street 1:4710 W 900 N
Mailing Address - Street 2:
Mailing Address - City:WHEATFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46392-9684
Mailing Address - Country:US
Mailing Address - Phone:219-671-0771
Mailing Address - Fax:219-956-0541
Practice Address - Street 1:4710 W 900 N
Practice Address - Street 2:
Practice Address - City:WHEATFIELD
Practice Address - State:IN
Practice Address - Zip Code:46392-9684
Practice Address - Country:US
Practice Address - Phone:219-671-0771
Practice Address - Fax:219-956-0541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN200898230A320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200898230AMedicaid