Provider Demographics
NPI:1326318577
Name:SIERRA FOREVER FAMILIES
Entity Type:Organization
Organization Name:SIERRA FOREVER FAMILIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-368-5114
Mailing Address - Street 1:345 CROWN POINT CIRCLE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945
Mailing Address - Country:US
Mailing Address - Phone:530-478-0900
Mailing Address - Fax:530-478-0982
Practice Address - Street 1:345 CROWN POINT CIRCLE
Practice Address - Street 2:SUITE 300
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945
Practice Address - Country:US
Practice Address - Phone:530-478-0900
Practice Address - Fax:530-478-0982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-05
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health