Helen Dike
Individual provider Active NPI Nursing Home Administrator · Globe, AZ
NPI 1013570753 · NPPES record last updated Apr 18, 2019
Key facts
- NPI
- 1013570753
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nursing Home Administrator 376G00000X
- License
- AL11076H (AZ)
- Practice address
- 320 E Oak St
Globe, AZ 85501-2145 - Phone
- (480) 203-5862
- NPI assigned
- Apr 18, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL11076H | AZ | MD | Nursing Home Administrator |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Just Liv Behavioral Home LLC | Current | Accepting new patients | |
| Ac Assisted Living | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Home Administrator | 376G00000X | AL11076H | AZ | Yes |
Addresses
Primary practice location
320 E Oak St
Globe, AZ 85501-2145
Mailing address
14848 N 15TH Dr
Phoenix, AZ 85023-5181
Phone (480) 203-5862
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AL11076H | Medicaid | AZ |
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All providers in Globe, AZ · Nursing Home Administrator in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.