Provider Demographics
NPI:1538206917
Name:RENOVATIONS FOR LIFE LLC
Entity type:Organization
Organization Name:RENOVATIONS FOR LIFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BERTOLET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-535-4339
Mailing Address - Street 1:6644 N US HIGHWAY 31
Mailing Address - Street 2:
Mailing Address - City:WHITELAND
Mailing Address - State:IN
Mailing Address - Zip Code:46184-9553
Mailing Address - Country:US
Mailing Address - Phone:317-535-4339
Mailing Address - Fax:317-535-6970
Practice Address - Street 1:6644 N US HIGHWAY 31
Practice Address - Street 2:
Practice Address - City:WHITELAND
Practice Address - State:IN
Practice Address - Zip Code:46184-9553
Practice Address - Country:US
Practice Address - Phone:317-535-4339
Practice Address - Fax:317-535-6970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty