Provider Demographics
NPI:1245926997
Name:SIERRA HOME CARE, LLC
Entity type:Organization
Organization Name:SIERRA HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:SUNGJIN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-393-0063
Mailing Address - Street 1:2064 MARENGO ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-1353
Mailing Address - Country:US
Mailing Address - Phone:323-576-2250
Mailing Address - Fax:323-576-2252
Practice Address - Street 1:2064 MARENGO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1353
Practice Address - Country:US
Practice Address - Phone:323-576-2250
Practice Address - Fax:323-576-2252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care