Provider Demographics
NPI:1851574305
Name:WESTCARE NEVADA INC
Entity Type:Organization
Organization Name:WESTCARE NEVADA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTBALS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-385-2090
Mailing Address - Street 1:PO BOX 94378
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89193-4378
Mailing Address - Country:US
Mailing Address - Phone:702-385-2090
Mailing Address - Fax:702-924-2575
Practice Address - Street 1:323 N MARYLAND PKWY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-3130
Practice Address - Country:US
Practice Address - Phone:702-853-3330
Practice Address - Fax:702-924-2575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X, 251B00000X, 251S00000X
NVN35000041112243324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100511279Medicaid
NV100508912Medicaid