Provider Demographics
NPI:1912308990
Name:OWNER BUILDER ASSISTANCE CORP
Entity Type:Organization
Organization Name:OWNER BUILDER ASSISTANCE CORP
Other - Org Name:OWNER BUILDER ASSISTANCE CORP DBA HANDYPRO OF SE FLORIDA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MALONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-339-9575
Mailing Address - Street 1:2357 SW ANTIQUERA ST
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-2436
Mailing Address - Country:US
Mailing Address - Phone:561-339-9575
Mailing Address - Fax:772-236-9596
Practice Address - Street 1:2357 SW ANTIQUERA ST
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-2436
Practice Address - Country:US
Practice Address - Phone:561-339-9575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-10
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCGC038404171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty