Provider Demographics
NPI:1275941023
Name:WESTCARE NEVADA
Entity Type:Organization
Organization Name:WESTCARE NEVADA
Other - Org Name:CIC PAHRUMP
Other - Org Type:Other Name
Authorized Official - Title/Position:AREA DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KINARD
Authorized Official - Suffix:
Authorized Official - Credentials:NCC, LCADC
Authorized Official - Phone:702-385-2090
Mailing Address - Street 1:1711 WHITNEY MESA DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-2080
Mailing Address - Country:US
Mailing Address - Phone:702-385-2090
Mailing Address - Fax:702-924-2575
Practice Address - Street 1:1161 S LOOP RD
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-4764
Practice Address - Country:US
Practice Address - Phone:775-751-6990
Practice Address - Fax:775-751-6992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1700223088OtherPT 17 NPI PAH