Organization
GRANDMOTHER'S CRIB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVANGELINE BELTEJAR-DIFUNTORUM (OWNER)
(775) 530-5745
Entity
Organization
Contact information
Practice address
700 SIENNA STATION WAY, RENO, NV 89512-1363
(775) 470-5313
(775) 470-5191
Mailing address
700 SIENNA STATION WAY, RENO, NV 89512-1363
(775) 470-5313
(775) 470-5191
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
5703AGC-12
NV
Other
Enumeration date
04/12/2016
Last updated
04/12/2016
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