Provider Demographics
NPI:1376398909
Name:ONE CROWN SERVICES, LLC
Entity Type:Organization
Organization Name:ONE CROWN SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:TUAKALAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-544-2291
Mailing Address - Street 1:7675 DIAMOND VISTA CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89506-5764
Mailing Address - Country:US
Mailing Address - Phone:775-544-2291
Mailing Address - Fax:
Practice Address - Street 1:7675 DIAMOND VISTA CT
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89506-5764
Practice Address - Country:US
Practice Address - Phone:775-544-2291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities