Organization
MAPLE STAR NEVADA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BREEANN HOERNING (AR BILLING MANAGER)
52074766594
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
(775) 738-2484
(775) 738-5756
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/12/2007
Last updated
08/22/2020
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