Provider Demographics
NPI:1740907609
Name:3R HOME IMPROVEMENT, LLC
Entity type:Organization
Organization Name:3R HOME IMPROVEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:COX
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:313-671-5377
Mailing Address - Street 1:1460 PENNSYLVANIA RD
Mailing Address - Street 2:
Mailing Address - City:WYANDOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48192-7035
Mailing Address - Country:US
Mailing Address - Phone:313-389-9931
Mailing Address - Fax:866-469-5869
Practice Address - Street 1:1460 PENNSYLVANIA RD
Practice Address - Street 2:
Practice Address - City:WYANDOTTE
Practice Address - State:MI
Practice Address - Zip Code:48192-7035
Practice Address - Country:US
Practice Address - Phone:313-389-9931
Practice Address - Fax:866-469-5869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI000006803Medicaid