Brothers Redevelopment, Inc

Primary specialty

Home Modifications ContractorTaxonomy code 171WH0202X

License

812658 Issued in CO

Legal business name

BROTHERS REDEVELOPMENT, INC

Practice address

2250 Eaton St
Garden LVL B
Edgewater, CO 80214-1276

Phone

(303) 685-4228

NPI assigned

Aug 26, 2016

Last updated

Aug 26, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Yvonne Duvall

Title

Compliance Manager

Phone

(303) 685-4228

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472169600000",
    "number": "1255887683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 EATON ST",
            "address_2": "GARDEN LVL B",
            "city": "EDGEWATER",
            "state": "CO",
            "postal_code": "802141276",
            "telephone_number": "303-685-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 EATON ST",
            "address_2": "GARDEN LVL B",
            "city": "EDGEWATER",
            "state": "CO",
            "postal_code": "802141276",
            "telephone_number": "303-685-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROTHERS REDEVELOPMENT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-26",
        "last_updated": "2016-08-26",
        "status": "A",
        "authorized_official_last_name": "DUVALL",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_title_or_position": "COMPLIANCE MANAGER",
        "authorized_official_telephone_number": "303-685-4228"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "CO",
            "license": "812658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04139259",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Modifications Contractor in Edgewater, CO
• Providers in Edgewater, CO by specialty
• Home Modifications Contractor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.