Provider Demographics
NPI:1780277814
Name:SIERRA HEALTH AND WELLNESS CENTERS LLC
Entity type:Organization
Organization Name:SIERRA HEALTH AND WELLNESS CENTERS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF REVENUE OFFICE
Authorized Official - Prefix:MS
Authorized Official - First Name:THI
Authorized Official - Middle Name:
Authorized Official - Last Name:HOANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-205-8232
Mailing Address - Street 1:2167 MONTGOMERY ST STE 100
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965-4945
Mailing Address - Country:US
Mailing Address - Phone:702-205-8232
Mailing Address - Fax:
Practice Address - Street 1:7996 OLD WINDING WAY STE 300
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-7159
Practice Address - Country:US
Practice Address - Phone:530-854-4119
Practice Address - Fax:530-854-4118
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIERRA HEALTH AND WELLNESS CENTERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-19
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health