| Organization Name: | WACH |
| NPI Number: | 1396800975 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LEZLIE KEITH BEARD (LVN 68WM6) |
| Mailing Address: | 1801 E Rimrock Rd Apt P21 Box114 Barstow |
| State: | CA US |
| Postal Code: | 923115745 |
| Phone Number: | 6617178268 |
| Fax Number: | |
| NPI Enumeration Date: | 12/26/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 286500000X |
| License Number: | 207529 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | Military Hospital |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A health care facility operated by the Department of Defense. |