Healthcare Provider Details

I. General information

NPI: 1740913607
Provider Name (Legal Business Name): ERH WCH OPCO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2022
Last Update Date: 07/11/2022
Certification Date: 07/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5975 W TWAIN AVE
LAS VEGAS NV
89103-1237
US

IV. Provider business mailing address

5975 W TWAIN AVE
LAS VEGAS NV
89103-1237
US

V. Phone/Fax

Practice location:
  • Phone: 702-368-7700
  • Fax:
Mailing address:
  • Phone: 702-368-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: BRIAN MURPHY
Title or Position: DIR. OF OPERATIONS
Credential:
Phone: 702-368-7700