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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