Provider Demographics
NPI:1942660972
Name:HELGA L JEROME
Entity Type:Organization
Organization Name:HELGA L JEROME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:HELGA
Authorized Official - Middle Name:L
Authorized Official - Last Name:JEROME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-348-7155
Mailing Address - Street 1:1100 BRIDLEWOOD PATH
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-9100
Mailing Address - Country:US
Mailing Address - Phone:775-348-7155
Mailing Address - Fax:
Practice Address - Street 1:1100 BRIDLEWOOD PATH
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-9100
Practice Address - Country:US
Practice Address - Phone:775-348-7155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVAPI9005037351Medicaid