Organization
MAPLE STAR NEVADA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES RICHARD TRIMBLE M.A. (PROGRAM DIRECTOR)
(702) 733-8098
Entity
Organization
Contact information
Practice address
2090 SEATTLE SHORE ST, LAS VEGAS, NV 89115-5227
(678) 361-1979
(702) 431-3512
Mailing address
2090 SEATTLE SHORE ST, LAS VEGAS, NV 89115-5227
(678) 361-1979
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/17/2009
Last updated
08/17/2009
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