Provider Demographics
NPI:1285095430
Name:R HOUSE COMMUNITY TREATMENT HOME
Entity type:Organization
Organization Name:R HOUSE COMMUNITY TREATMENT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ARTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-691-2161
Mailing Address - Street 1:483 CORVALLIS CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-6057
Mailing Address - Country:US
Mailing Address - Phone:775-853-4767
Mailing Address - Fax:775-853-4265
Practice Address - Street 1:483 CORVALLIS CT
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-6057
Practice Address - Country:US
Practice Address - Phone:775-853-4767
Practice Address - Fax:775-853-4265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV20111361581385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100510427Medicaid