Provider Demographics
NPI:1346480761
Name:THE FOUNDATION FOR THE STARS
Entity Type:Organization
Organization Name:THE FOUNDATION FOR THE STARS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TRUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-289-0157
Mailing Address - Street 1:3708 WATERHOLE ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-2907
Mailing Address - Country:US
Mailing Address - Phone:702-289-0157
Mailing Address - Fax:702-302-5026
Practice Address - Street 1:3708 WATERHOLE ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-2907
Practice Address - Country:US
Practice Address - Phone:702-289-0157
Practice Address - Fax:702-302-5026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-25
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness