Provider Demographics
NPI:1053076265
Name:COBUILT CONSTRUCTION SERVICES, LLC
Entity Type:Organization
Organization Name:COBUILT CONSTRUCTION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:YLITALO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-252-5971
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:MENAHGA
Mailing Address - State:MN
Mailing Address - Zip Code:56464-0008
Mailing Address - Country:US
Mailing Address - Phone:218-252-5971
Mailing Address - Fax:
Practice Address - Street 1:47 11TH ST SE
Practice Address - Street 2:
Practice Address - City:MENAHGA
Practice Address - State:MN
Practice Address - Zip Code:56464-3274
Practice Address - Country:US
Practice Address - Phone:218-252-5971
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health