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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
AL11076HAZMDNursing Home Administrator

Practice roles

OrganizationSpecialtyStatusNew patients
Just Liv Behavioral Home LLC Current Accepting new patients
Ac Assisted Living Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
AL11076HMedicaidAZ

Other providers in Globe, AZ

All providers in Globe, AZ · Nursing Home Administrator in Arizona

Sources for this page

Verify at the official NPI Registry.