Provider Demographics
NPI:1538498365
Name:BARNETT RESTORATION COMPANY, INC.
Entity Type:Organization
Organization Name:BARNETT RESTORATION COMPANY, INC.
Other - Org Name:BETTER LIFE HOME MOD SPECIALISTS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-286-4858
Mailing Address - Street 1:415 US HIGHWAY 51 BYP S
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-4260
Mailing Address - Country:US
Mailing Address - Phone:731-286-4858
Mailing Address - Fax:731-286-4858
Practice Address - Street 1:415 US HIGHWAY 51 BYP S
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-4260
Practice Address - Country:US
Practice Address - Phone:731-286-4858
Practice Address - Fax:731-286-6736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27772171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH445156Medicaid