Provider Demographics
NPI:1013793132
Name:STILLWATER TRIBAL SENIOR CENTER
Entity type:Organization
Organization Name:STILLWATER TRIBAL SENIOR CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOC DIRECTOR-BUSINESS SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:TRICHA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTCHCRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-423-3634
Mailing Address - Street 1:1001 RIO VISTA DR
Mailing Address - Street 2:
Mailing Address - City:FALLON
Mailing Address - State:NV
Mailing Address - Zip Code:89406-5463
Mailing Address - Country:US
Mailing Address - Phone:775-423-3634
Mailing Address - Fax:
Practice Address - Street 1:1001 RIO VISTA DR
Practice Address - Street 2:
Practice Address - City:FALLON
Practice Address - State:NV
Practice Address - Zip Code:89406-5463
Practice Address - Country:US
Practice Address - Phone:775-423-3634
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FALLON TRIBAL HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty