Organization
THE FOUNDATION FOR THE S.T.A.R.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRUDY ANISE PARKS (EXECUTIVE DIRECTOR)
(702) 289-0157
Entity
Organization
Contact information
Practice address
3708 WATERHOLE ST, LAS VEGAS, NV 89130-2907
(702) 515-1761
(702) 515-1761
Mailing address
PO BOX 530063, HENDERSON, NV 89053-0063
(702) 289-0157
(702) 892-0938
Taxonomy
Speciality
Code
Description
License number
State
261QC1800X
Corporate Health Clinic/Center
Primary
GF-125401040-0001
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100511029
—
NV
05
—
100511030
—
NV
Enumeration date
02/28/2007
Last updated
06/20/2008
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