Provider Demographics
NPI:1215534656
Name:DSGB CONSTRUCTION LLC
Entity Type:Organization
Organization Name:DSGB CONSTRUCTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:R
Authorized Official - Last Name:BLANKENSHIP
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:804-243-4603
Mailing Address - Street 1:14341 GENERATION LN
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23838-4200
Mailing Address - Country:US
Mailing Address - Phone:804-243-4603
Mailing Address - Fax:
Practice Address - Street 1:14341 GENERATION LN
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23838-4200
Practice Address - Country:US
Practice Address - Phone:804-243-4603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
No171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate VehicleGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPROPOSALOther051986
VA051986Other051986