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General NPI Number Information
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NPI Number | 1013403138
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Entity Type | Organization
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Legal Business Name | WE CARE RESIDENTIAL HOME, LLC
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Dates
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Enumeration Date | 07/02/2018
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Last Update Date | 07/02/2018
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Provider Practice Location Address
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Address Line | 3858 MOONGATE CIR
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City | LAS VEGAS
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State | NV
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Zip | 89103-0134
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Country | US
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Telephone | 702-945-6682
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Fax | 702-251-0335
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Provider Business Mailing Address
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Address Line | 3858 MOONGATE CIR
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City | LAS VEGAS
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State | NV
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Zip | 89103-0134
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Country | US
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Telephone | 702-945-6682
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Fax | 702-251-0335
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Authorized Official
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Title or Position | FACILITY MANAGER/OWNER
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Name | JUDITH LANGEN
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Credential |
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Telephone | 702-945-6682
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 9026-AGC-0
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License Number State | NV
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