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NPI 1740197789

NPI 1740197789 : HOME AT THE WILLOWS : LAS VEGAS, NV

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General NPI Number Information
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    NPI Number           |    1740197789
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    Entity Type          |    Organization 
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    Legal Business Name  |    HOME AT THE WILLOWS 
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Dates
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    Enumeration Date     |    08/25/2026
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    Last Update Date     |    08/25/2026
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Provider Practice Location Address
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    Address Line         |    10166 TIMBER WILLOW AVE 
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    City                 |    LAS VEGAS
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    State                |    NV
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    Zip                  |    89135-2014
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    Country              |    US
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    Telephone            |    702-882-3134
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    10166 TIMBER WILLOW AVE 
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    City                 |    LAS VEGAS
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    State                |    NV
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    Zip                  |    89135-2014
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    Country              |    US
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    Telephone            |    702-882-3134
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    Fax                  |    
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Authorized Official
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    Title or Position    |    DIRECTOR
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    Name                 |     BRITTANY  TESTA 
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    Credential           |    
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    Telephone            |    702-882-3134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    311ZA0620X
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    Taxonomy Name        |    Adult Care Home Facility
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    License Number       |    
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    License Number State |    
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