Provider Demographics
NPI:1124746342
Name:CLOUD 9 RENOVATIONS LLC
Entity type:Organization
Organization Name:CLOUD 9 RENOVATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CALEB
Authorized Official - Middle Name:
Authorized Official - Last Name:KETTERER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-377-8203
Mailing Address - Street 1:3578 HARTSEL DR UNIT E335
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-2103
Mailing Address - Country:US
Mailing Address - Phone:719-377-8203
Mailing Address - Fax:
Practice Address - Street 1:2750 KITTYHAWK RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-1441
Practice Address - Country:US
Practice Address - Phone:719-377-8203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-15
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty
No171W00000XOther Service ProvidersContractorGroup - Single Specialty