Healthcare Provider Details

I. General information

NPI: 1508386988
Provider Name (Legal Business Name): HELIX BEHAVIORAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2017
Last Update Date: 02/10/2023
Certification Date: 02/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3785 BAKER LN STE 201
RENO NV
89509-5454
US

IV. Provider business mailing address

3785 BAKER LN STE 201
RENO NV
89509-5454
US

V. Phone/Fax

Practice location:
  • Phone: 209-505-0634
  • Fax:
Mailing address:
  • Phone: 209-505-0634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-14-17036
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-17-32922
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. KENNETH JAMES KILLINGSWORTH
Title or Position: DIRECTOR
Credential: MA, BCBA
Phone: 209-968-0574