Provider Demographics
NPI:1447823869
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 OFFICER
Authorized Official - Prefix:MRS
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 1:9985 FOLSOM BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-1405
Mailing Address - Country:US
Mailing Address - Phone:866-303-6275
Mailing Address - Fax:
Practice Address - Street 1:3758 ILLINOIS AVE
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:CA
Practice Address - Zip Code:96021-9617
Practice Address - Country:US
Practice Address - Phone:530-854-4119
Practice Address - Fax:530-854-4119
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIERRA HEALTH AND WELLNESS CENTERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-22
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility