Healthcare Provider Details

I. General information

NPI: 1891392841
Provider Name (Legal Business Name): WESTCARE KENTUCKY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2020
Last Update Date: 10/02/2020
Certification Date: 09/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5971 POOR BOTTOM ROAD
ELKHORN CITY KY
41522
US

IV. Provider business mailing address

1711 WHITNEY MESA DR
HENDERSON NV
89014-2080
US

V. Phone/Fax

Practice location:
  • Phone: 606-754-7077
  • Fax:
Mailing address:
  • Phone: 702-385-2090
  • Fax: 702-924-2575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: FRANK RABBITO
Title or Position: COO
Credential:
Phone: 305-573-3784