Provider Demographics
NPI:1144490616
Name:LASTING IMPRESSIONS HOME REMODEL CENTER, LTD.
Entity type:Organization
Organization Name:LASTING IMPRESSIONS HOME REMODEL CENTER, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BILYEU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-837-7722
Mailing Address - Street 1:2168 N WATERFORD DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-2301
Mailing Address - Country:US
Mailing Address - Phone:314-837-7722
Mailing Address - Fax:314-837-0655
Practice Address - Street 1:2168 N WATERFORD DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-2301
Practice Address - Country:US
Practice Address - Phone:314-837-7722
Practice Address - Fax:314-837-0655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No171WV0202XOther Service ProvidersContractorVehicle ModificationsGroup - Multi-Specialty