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General NPI Number Information
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NPI Number | 1457899825
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Entity Type | Organization
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Legal Business Name | ERH RED ROCK OPCO
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Dates
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Enumeration Date | 02/06/2017
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 5975 W TWAIN AVE STE B
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City | LAS VEGAS
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State | NV
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Zip | 89103-1237
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Country | US
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Telephone | 725-605-0310
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Fax |
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Provider Business Mailing Address
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Address Line | 5975 W TWAIN AVE STE B
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City | LAS VEGAS
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State | NV
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Zip | 89103-1237
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Country | US
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Telephone | 725-605-0310
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | AUDWIN ANGOSTA
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Credential |
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Telephone | 725-605-0310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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