Organization
MAPLE STAR NEVADA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BREEANN HOERNING (AR BILLING MANAGER)
(520) 747-6694
Entity
Organization
Contact information
Practice address
495 IDAHO ST STE 101, ELKO, NV 89801-3713
(775) 738-2484
(775) 738-5756
Mailing address
620 N CRAYCROFT RD, TUCSON, AZ 85711-1448
(520) 747-6694
(520) 747-6613
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/09/2007
Last updated
08/22/2020
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