Provider Demographics
NPI:1205310984
Name:SIERRA WEST HOME CARE, INC.
Entity type:Organization
Organization Name:SIERRA WEST HOME CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:PELTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-313-0600
Mailing Address - Street 1:1750 14TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-4353
Mailing Address - Country:US
Mailing Address - Phone:310-313-0600
Mailing Address - Fax:310-313-0677
Practice Address - Street 1:1750 14TH ST STE A
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-4353
Practice Address - Country:US
Practice Address - Phone:310-313-0600
Practice Address - Fax:310-313-0677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-19
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care