Provider Demographics
NPI:1386828770
Name:ACADEMY OF THE SIERRAS
Entity Type:Organization
Organization Name:ACADEMY OF THE SIERRAS
Other - Org Name:WELLSPRING ACADEMY
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:828-877-2215
Mailing Address - Street 1:1 LAMBS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BREVARD
Mailing Address - State:NC
Mailing Address - Zip Code:28712
Mailing Address - Country:US
Mailing Address - Phone:828-877-2215
Mailing Address - Fax:828-877-2762
Practice Address - Street 1:1 LAMBS CREEK RD
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712
Practice Address - Country:US
Practice Address - Phone:828-877-2215
Practice Address - Fax:828-877-2762
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CRC HEALTH CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities