Provider Demographics
NPI:1164222436
Name:WESTCOAST CARE LLC
Entity type:Organization
Organization Name:WESTCOAST CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:LEM
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:424-208-4630
Mailing Address - Street 1:2669 GALLARATE DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89044-1863
Mailing Address - Country:US
Mailing Address - Phone:424-208-4630
Mailing Address - Fax:
Practice Address - Street 1:2669 GALLARATE DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89044-1863
Practice Address - Country:US
Practice Address - Phone:424-208-4630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty