Sierra Care At The Lake,llc
Skilled Nursing Facility in Clovis, CA. Organization (NPI-2).
NPI number1336799170
StatusActive
Last updated in NPPESSep 13, 2019
Details
- NPI
- 1336799170
- Entity type
- Organization (NPI-2)
- Legal business name
- Sierra Care At The Lake,llc
- Organization subpart
- No
- Enumeration date
- Sep 13, 2019
- Last updated
- Sep 13, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | – | – | Yes |
| 311Z00000X | Custodial Care Facility | – | – | |
| 313M00000X | Nursing Facility/Intermediate Care Facility | – | – | |
| 315D00000X | Hospice, Inpatient | – | – |
Other names
- Sierra Care Clovis (Doing Business As)
Practice location
648 W Sierra AveClovis, CA 93612-0151
Phone 559-325-6100 · Fax 559-553-8840
Mailing address
648 W Sierra AveClovis, CA 93612-0151
Phone 559-325-6100 · Fax 559-553-8840
Authorized official
Gary Andrew Ponticiello
President
5595392727
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