NPIMap

Organization Active NPI

Maple Star Nevada

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tucson, AZ
National Provider Identifier
1023159506
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MAPLE STAR NEVADA
Practice address
620 N Craycroft Rd
Tucson, AZ 85711-1448
Phone
(520) 747-6694
Fax
(520) 747-6613
NPI assigned
Feb 9, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Breeann Hoerning
Title
Ar & Billibg Manager
Phone
(520) 747-6694

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

620 N Craycroft Rd
Tucson, AZ 85711-1448

Mailing address

620 N Craycroft Rd
Tucson, AZ 85711-1448
Phone (520) 747-6694

Other identifiers 1

IdentifierTypeStateIssuer
100508814MedicaidAZ

National Provider Directory

National Provider Directory
Tax ID family
Maple Star41 organizations share this tax ID, including this one

Other organizations with this tax ID 40

Organizations that report the same tax identification number in the National Provider Directory.

View all 40

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023159506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 N CRAYCROFT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111448",
            "telephone_number": "520-747-6694",
            "fax_number": "520-747-6613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N CRAYCROFT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111448",
            "telephone_number": "520-747-6694",
            "fax_number": "520-747-6613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE STAR NEVADA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOERNING",
        "authorized_official_first_name": "BREEANN",
        "authorized_official_title_or_position": "AR & BILLIBG MANAGER",
        "authorized_official_telephone_number": "520-747-6694"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100508814",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.