Provider Demographics
NPI:1922475128
Name:RICHARD STEELE FOUNDATION
Entity Type:Organization
Organization Name:RICHARD STEELE FOUNDATION
Other - Org Name:RICHARD STEELE BOXING GYM
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-491-9036
Mailing Address - Street 1:2475 W CHEYENNE AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-4329
Mailing Address - Country:US
Mailing Address - Phone:702-638-1308
Mailing Address - Fax:
Practice Address - Street 1:2475 W CHEYENNE AVE STE 110
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-4329
Practice Address - Country:US
Practice Address - Phone:702-638-1308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management