Healthcare Provider Details

I. General information

NPI: 1013631878
Provider Name (Legal Business Name): WE DO CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2022
Last Update Date: 09/26/2022
Certification Date: 09/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4315 N RANCHO DR STE 110
LAS VEGAS NV
89130-3437
US

IV. Provider business mailing address

10519 REGAL STALLION AVE
LAS VEGAS NV
89135-2156
US

V. Phone/Fax

Practice location:
  • Phone: 702-862-6166
  • Fax:
Mailing address:
  • Phone: 702-862-6166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: YANCHAO FAN
Title or Position: OWNER
Credential:
Phone: 702-862-6166