Provider Demographics
NPI:1952960346
Name:AMERICAN HOME COMPANION, INC.
Entity Type:Organization
Organization Name:AMERICAN HOME COMPANION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MONTERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-826-8090
Mailing Address - Street 1:3708 LAKESIDE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-5371
Mailing Address - Country:US
Mailing Address - Phone:775-826-8090
Mailing Address - Fax:775-826-9008
Practice Address - Street 1:3708 LAKESIDE DR STE 200
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-5371
Practice Address - Country:US
Practice Address - Phone:775-826-8090
Practice Address - Fax:775-826-9008
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN HOME COMPANION, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV9005048044Medicaid
NV003016623Medicaid