| Organization Name: | MOBILE HOME SPECIALIST |
| NPI Number: | 1356769103 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LEWIS M NOLEN (OWNER) |
| Mailing Address: | 322 Horseshoe Bend Rd Goldendale |
| State: | WA US |
| Postal Code: | 986203604 |
| Phone Number: | 5099668495 |
| Fax Number: | 5092480648 |
| NPI Enumeration Date: | 03/30/2014 |
| NPI Last Update Date: | 03/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171WH0202X |
| License Number: | MOBILHS088MP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Contractor |
| Taxonomy Specialization: | Home Modifications |
| Taxonomy Definition: | |