Provider Demographics
NPI:1639559933
Name:WESTCARE TENNESSEE, INC.
Entity Type:Organization
Organization Name:WESTCARE TENNESSEE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF SERVICES AND PROGRAMS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:NERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-490-6767
Mailing Address - Street 1:PO BOX 94738
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89193-4738
Mailing Address - Country:US
Mailing Address - Phone:702-385-2090
Mailing Address - Fax:702-924-2575
Practice Address - Street 1:2415 N GATEWAY AVE
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:TN
Practice Address - Zip Code:37748-8609
Practice Address - Country:US
Practice Address - Phone:865-234-7030
Practice Address - Fax:865-882-9411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-02
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)