Provider Demographics
NPI:1396276739
Name:ASPEN DESIGN RENOVATIONS, LLC
Entity type:Organization
Organization Name:ASPEN DESIGN RENOVATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:TANNER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:303-345-7683
Mailing Address - Street 1:5401 S GARLAND WAY
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-7456
Mailing Address - Country:US
Mailing Address - Phone:303-345-7683
Mailing Address - Fax:303-933-3714
Practice Address - Street 1:5401 S GARLAND WAY
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-7456
Practice Address - Country:US
Practice Address - Phone:303-345-7683
Practice Address - Fax:303-933-3714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-27
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO171WH0202XOtherHOME MODIFICATIONS