Provider Demographics
NPI:1902266067
Name:JAHN FAMILY LTD
Entity Type:Organization
Organization Name:JAHN FAMILY LTD
Other - Org Name:LOFTWINDS II
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:KURTIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:JAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-329-4005
Mailing Address - Street 1:1072 EVANS AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89512-2806
Mailing Address - Country:US
Mailing Address - Phone:775-329-4005
Mailing Address - Fax:
Practice Address - Street 1:1072 EVANS AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89512-2806
Practice Address - Country:US
Practice Address - Phone:775-329-4005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV9005046972Medicaid