Provider Demographics
NPI:1962796409
Name:QUAD CITIES REMODELING
Entity type:Organization
Organization Name:QUAD CITIES REMODELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:FELIPE
Authorized Official - Middle Name:JESSIE
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-386-5067
Mailing Address - Street 1:605 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-5832
Mailing Address - Country:US
Mailing Address - Phone:469-386-5067
Mailing Address - Fax:877-362-9841
Practice Address - Street 1:605 E MAIN ST
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-5832
Practice Address - Country:US
Practice Address - Phone:469-386-5067
Practice Address - Fax:877-362-9841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty