MY HOME ICE NPI 1154614105

NPI Information

NPI: 1154614105
Provider Name: MY HOME ICE
Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
10880 DEODAR WAY
RENO, NV
ZIP 89506
Phone: (775) 786-4168
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MY HOME ICE is a community based residential treatment facility mental illness in Reno, NV. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. MY HOME ICE NPI is 1154614105. The provider is registered as an organization entity type.

The provider's business location address is:

10880 DEODAR WAY
RENO, NV
ZIP 89506-064
Phone: (775) 786-4168
Fax: (775) 786-5622

The provider's authorized official is Elizabeth Robin Webb .
The authorized official title is Program Director and has the following contact phone number (702) 595-2868.

The enumeration date for this NPI number is 5/24/2011 and was last updated on 5/24/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320800000X	Community Based Residential Treatment Facility, Mental Illness			NEVADA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	9005042666	MEDICAID	NEVADA
2	9005052384	MEDICARE OSCAR/CERTIFICATION	NEVADA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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