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Organization
CREST HEALTHCARE INC.
Active
Organization
CREST HEALTHCARE INC.
Active
Other names
Crest Healthcare Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HEYWARD JACKSON JR. (DIRECTOR)
(702) 589-3095
Entity
Organization
Contact information
Practice address
3275 S JONES BLVD STE 106, LAS VEGAS, NV 89146-6768
(702) 589-3095
Mailing address
3651 LINDELL RD # D748, LAS VEGAS, NV 89103-1254
(702) 589-3095
(866) 499-2117
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033555958
—
NV
Enumeration date
09/11/2020
Last updated
03/05/2021
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