Provider Demographics
NPI:1083360895
Name:MIKE'S UPKEEP HOME MAINTENANCE , LLC
Entity Type:Organization
Organization Name:MIKE'S UPKEEP HOME MAINTENANCE , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TABATHA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:SHEPARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-441-1789
Mailing Address - Street 1:622 S 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-3839
Mailing Address - Country:US
Mailing Address - Phone:970-441-1789
Mailing Address - Fax:
Practice Address - Street 1:622 S 6TH AVE
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-3839
Practice Address - Country:US
Practice Address - Phone:970-441-1789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-02
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty