MEDICARE: ERH RED ROCK OPCO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	283Q00000X	Psychiatric Hospital

General Provider Information

NPI Number	:	1457899825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERH RED ROCK OPCO

Provider Business Mailing Address
First Line	:	5975 W TWAIN AVE STE B
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-1237
Country	:	US
Telephone Number	:	725-605-0310
Fax Number	:

Provider Business Practice Location Address
First Line	:	5975 W TWAIN AVE STE B
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-1237
Country	:	US
Telephone Number	:	725-605-0310
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	AUDWIN ANGOSTA
Credential	:
Telephone Number	:	725-605-0310

Provider Enumeration Date	:	02/06/2017
Last Update Date	:	07/24/2023

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Directions to “ERH RED ROCK OPCO ” Practice Location

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