Provider Demographics
NPI:1003593807
Name:HELMS GORDON LLC
Entity Type:Organization
Organization Name:HELMS GORDON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SOPRANO
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:704-301-7562
Mailing Address - Street 1:714 FUNDERBURKE RD
Mailing Address - Street 2:
Mailing Address - City:FORT LAWN
Mailing Address - State:SC
Mailing Address - Zip Code:29714-8593
Mailing Address - Country:US
Mailing Address - Phone:704-301-7562
Mailing Address - Fax:
Practice Address - Street 1:714 FUNDERBURKE RD
Practice Address - Street 2:
Practice Address - City:FORT LAWN
Practice Address - State:SC
Practice Address - Zip Code:29714-8593
Practice Address - Country:US
Practice Address - Phone:704-301-7562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility