Provider Demographics
NPI:1366299000
Name:SIERRA HEALTH AND WELLNESS
Entity type:Organization
Organization Name:SIERRA HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF REVENUE OFFICER
Authorized Official - Prefix:
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:530-430-3067
Practice Address - Street 1:107 COYOTE MOON TRAIL
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:CA
Practice Address - Zip Code:95914
Practice Address - Country:US
Practice Address - Phone:866-303-6275
Practice Address - Fax:530-430-3067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-01
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility