MEDICARE: ERH WCH OPCO, LLC

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	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NV20222405371	OTHER	NV	NV BUSINESS ID

General Provider Information

NPI Number	:	1740913607
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERH WCH OPCO, LLC

Provider Business Mailing Address
First Line	:	5975 W TWAIN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-1237
Country	:	US
Telephone Number	:	702-368-7700
Fax Number	:

Provider Business Practice Location Address
First Line	:	5975 W TWAIN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-1237
Country	:	US
Telephone Number	:	702-368-7700
Fax Number	:

Authorized Official
Title or Position	:	DIR. OF OPERATIONS
Name	:	BRIAN MURPHY
Credential	:
Telephone Number	:	702-368-7700

Provider Enumeration Date	:	07/07/2022
Last Update Date	:	07/11/2022

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Directions to “ERH WCH OPCO, LLC ” Practice Location

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