Provider Demographics
NPI:1114315512
Name:MY JOURNEY HOME, INC
Entity Type:Organization
Organization Name:MY JOURNEY HOME, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:VOIGT
Authorized Official - Suffix:
Authorized Official - Credentials:AA
Authorized Official - Phone:775-825-8126
Mailing Address - Street 1:1055 W MOANA LN
Mailing Address - Street 2:SUITE 204
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-4776
Mailing Address - Country:US
Mailing Address - Phone:775-825-8126
Mailing Address - Fax:775-825-8119
Practice Address - Street 1:1055 W MOANA LN
Practice Address - Street 2:SUITE 204
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-4776
Practice Address - Country:US
Practice Address - Phone:775-825-8126
Practice Address - Fax:775-825-8119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-07
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV20041492188Other20041492188