Provider Demographics
NPI:1922761915
Name:FRONT PORCH CUSTOM BUILDERS, LLC
Entity Type:Organization
Organization Name:FRONT PORCH CUSTOM BUILDERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:COLVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-307-4021
Mailing Address - Street 1:5667 YORK RD SW
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-7423
Mailing Address - Country:US
Mailing Address - Phone:614-307-4021
Mailing Address - Fax:
Practice Address - Street 1:5667 YORK RD SW
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-7423
Practice Address - Country:US
Practice Address - Phone:614-307-4021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty