Healthcare Provider Details

I. General information

NPI: 1144638180
Provider Name (Legal Business Name): WESTCARE NEVADA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2014
Last Update Date: 07/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 S MARTIN LUTHER KING BLVD
LAS VEGAS NV
89106-4313
US

IV. Provider business mailing address

1711 WHITNEY MESA DR
HENDERSON NV
89014-2080
US

V. Phone/Fax

Practice location:
  • Phone: 702-385-3330
  • Fax: 702-385-5519
Mailing address:
  • Phone: 702-385-2090
  • Fax: 702-924-2575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. ERIN KINARD
Title or Position: AREA DIRECTOR
Credential: NCC,LCADC
Phone: 702-385-2090