Healthcare Provider Details

I. General information

NPI: 1740197789
Provider Name (Legal Business Name): HOME AT THE WILLOWS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10166 TIMBER WILLOW AVE
LAS VEGAS NV
89135-2014
US

IV. Provider business mailing address

10166 TIMBER WILLOW AVE
LAS VEGAS NV
89135-2014
US

V. Phone/Fax

Practice location:
  • Phone: 702-882-3134
  • Fax:
Mailing address:
  • Phone: 702-882-3134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: BRITTANY TESTA
Title or Position: DIRECTOR
Credential:
Phone: 702-882-3134