Provider Demographics
NPI:1881851178
Name:SIERRA HOME HEALTH CARE
Entity Type:Organization
Organization Name:SIERRA HOME HEALTH CARE
Other - Org Name:SIERRA SENIOR CARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TED
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-359-7272
Mailing Address - Street 1:3500 LAKESIDE CT
Mailing Address - Street 2:SUITE 204
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-4829
Mailing Address - Country:US
Mailing Address - Phone:775-359-7272
Mailing Address - Fax:775-825-1344
Practice Address - Street 1:3500 LAKESIDE CT
Practice Address - Street 2:SUITE 204
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-4829
Practice Address - Country:US
Practice Address - Phone:775-359-7272
Practice Address - Fax:775-825-1344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV9005045958Medicaid
NV003016632Medicaid
NV100500353Medicaid
NV100509181Medicaid
NV9005006109Medicaid
NV9005037450Medicaid