Organization
MAR VON SENIOR CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESA CRUZ BASALLO RN (ADMINISTRATOR)
(775) 323-4696
Entity
Organization
Contact information
Practice address
300 LA RUE AVE, RENO, NV 89509-2014
(775) 323-4696
(775) 626-4605
Mailing address
4816 CRESTSIDE DR, SPARKS, NV 89436-3667
(775) 323-4696
(775) 626-4605
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
285AGC12
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005716019
—
NV
Enumeration date
01/08/2007
Last updated
02/16/2016
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