Provider Demographics
NPI:1730315599
Name:HELMS RESIDENTIAL MANAGEMENT LLC
Entity Type:Organization
Organization Name:HELMS RESIDENTIAL MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:HELMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-851-3715
Mailing Address - Street 1:PO BOX 37730
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27627-7730
Mailing Address - Country:US
Mailing Address - Phone:919-851-3715
Mailing Address - Fax:919-465-3872
Practice Address - Street 1:2305 GLASCOCK ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1601
Practice Address - Country:US
Practice Address - Phone:919-851-3715
Practice Address - Fax:919-465-3872
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HELMS RESIDENTIAL MANAGMENT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-08
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-092-028310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7805996Medicaid
NC7803748Medicaid
NC7803749Medicaid
NC7802145Medicaid
NC7803143Medicaid