Provider Demographics
NPI:1740803212
Name:SIERRA COUNTY DRUG AND ALCOHOL
Entity Type:Organization
Organization Name:SIERRA COUNTY DRUG AND ALCOHOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUD PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:SZOPA
Authorized Official - Suffix:
Authorized Official - Credentials:SUDCC II
Authorized Official - Phone:530-993-6746
Mailing Address - Street 1:PO BOX 38
Mailing Address - Street 2:
Mailing Address - City:DOWNIEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95936-0038
Mailing Address - Country:US
Mailing Address - Phone:530-289-3711
Mailing Address - Fax:530-289-3716
Practice Address - Street 1:22 MAIDEN LN
Practice Address - Street 2:
Practice Address - City:DOWNIEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95936
Practice Address - Country:US
Practice Address - Phone:530-289-3711
Practice Address - Fax:530-289-3716
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIERRA COUNTY DRUG AND ALCOHOL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder