Healthcare Provider Details

I. General information

NPI: 1447798392
Provider Name (Legal Business Name): WESTCARE NEVADA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

323 N MARYLAND PKWY
LAS VEGAS NV
89101-3130
US

IV. Provider business mailing address

PO BOX 94738
LAS VEGAS NV
89193-4738
US

V. Phone/Fax

Practice location:
  • Phone: 702-385-3330
  • Fax: 702-924-2575
Mailing address:
  • Phone: 702-385-2090
  • Fax: 702-924-2575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KEVIN MORSS
Title or Position: VICE PRESIDENT
Credential:
Phone: 702-385-2090