Organization
MAPLE STAR NEVADA
Active
Parent organization
PROVIDENCE
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE
Authorized official
MRS. CHERYL CHRISTINA GRIMES (THERAPUTIC FOSTER PARENT)
(775) 852-8335
Entity
Organization
Contact information
Practice address
8455 OFFENHAUSER DR, #517, RENO, NV 89511
(775) 852-8335
Mailing address
8455 OFFENHAUSER DR, #517, RENO, NV 89511-1752
(775) 852-8335
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
FF-125404617
NV
253J00000X
Foster Care Agency
GF880321776-0316
NV
Other
Enumeration date
06/15/2011
Last updated
06/15/2011
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