Provider Demographics
NPI:1417394792
Name:WESTCARE NEVADA
Entity Type:Organization
Organization Name:WESTCARE NEVADA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUKIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-348-8811
Mailing Address - Street 1:401 S MARTIN LUTHER KING BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4313
Mailing Address - Country:US
Mailing Address - Phone:702-385-3642
Mailing Address - Fax:702-924-2575
Practice Address - Street 1:315 RECORD ST
Practice Address - Street 2:STE 103
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89512-3327
Practice Address - Country:US
Practice Address - Phone:775-996-1970
Practice Address - Fax:775-786-2418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-28
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit