Provider Demographics
NPI:1356855183
Name:CUSTOM CORPORATES, INC.
Entity Type:Organization
Organization Name:CUSTOM CORPORATES, INC.
Other - Org Name:CLOSENEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:SEAN
Authorized Official - Last Name:TRAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-439-7417
Mailing Address - Street 1:2699 FESSEY CT STE 105
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-3153
Mailing Address - Country:US
Mailing Address - Phone:615-665-8588
Mailing Address - Fax:
Practice Address - Street 1:2699 FESSEY CT STE 105
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-3153
Practice Address - Country:US
Practice Address - Phone:615-665-8588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-01
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging