Provider Demographics
NPI:1437752334
Name:SIERRA QUEST HUMAN SERVICES FOUNDATION, INC.
Entity Type:Organization
Organization Name:SIERRA QUEST HUMAN SERVICES FOUNDATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:SEYMOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-966-7095
Mailing Address - Street 1:6986 SCOTT RD
Mailing Address - Street 2:
Mailing Address - City:MARIPOSA
Mailing Address - State:CA
Mailing Address - Zip Code:95338-9639
Mailing Address - Country:US
Mailing Address - Phone:209-966-7095
Mailing Address - Fax:
Practice Address - Street 1:6986 SCOTT RD
Practice Address - Street 2:
Practice Address - City:MARIPOSA
Practice Address - State:CA
Practice Address - Zip Code:95338-9639
Practice Address - Country:US
Practice Address - Phone:209-966-7095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIERRA QUEST HUMAN SERVICES FOUNDATION INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-21
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251B00000XAgenciesCase Management
No253J00000XAgenciesFoster Care Agency
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children