SIERRA RECOVERY CENTER (NPI# 1295949451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295949451 |
| Entity Type | Organization |
| Organization Name | SIERRA RECOVERY CENTER |
| Practice Address |
931 Macinaw Rd South Lake Tahoe CA 96150-3525 |
| Mailing Address |
1137 Emerald Bay Rd South Lake Tahoe CA 96150-6207 |
| Practice Telephone | 5305415440 |
| Practice Fax Number | 5305410456 |
| Mailing Telephone | 5305415190 |
| Mailing Fax Number | 5305416031 |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. ELIXABETH FEDOR (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5305415190 |
| Authorized Official Credential | LADC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 090003CN | CA | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346443223 | Sierra Recovery Center | Community/Behavioral Health | 2677 Reaves St, South Lake Tahoe, CA 96150-3529 | 2007-06-07 |
| 1144423021 | Sierra Recovery Center | Substance Abuse Rehabilitation Facility | 921 Macinaw Rd # 3, South Lake Tahoe, CA 96150-3525 | 2007-06-07 |
| 1568665446 | Sierra Recovery Center | Community/Behavioral Health | 921 Macinaw Rd # 4, South Lake Tahoe, CA 96150-3525 | 2007-06-07 |
| 1477756351 | Sierra Recovery Center | Community/Behavioral Health | 921 Macinaw Rd Apt 1, South Lake Tahoe, CA 96150-3525 | 2007-06-07 |
| 1336352053 | Sierra Recovery Center | Community/Behavioral Health | 1137 Emerald Bay Rd, South Lake Tahoe, CA 96150-6207 | 2007-05-08 |
| 1093954653 | Sierra Recovery Center | Substance Abuse Rehabilitation Facility | 1137 Emerald Bay Rd, South Lake Tahoe, CA 96150-6207 | 2009-02-05 |
| 1346426962 | Sierra Recovery Center | Health Maintenance Organization | 1137 Emerald Bay Rd, South Lake Tahoe, CA 96150-6207 | 2008-01-14 |
| 1780878942 | Sierra Recovery Center | Substance Abuse Rehabilitation Facility | 1137 Emerald Bay Rd, South Lake Tahoe, CA 96150-6207 | 2007-08-30 |
| Street Address |
931 MACINAW RD |
| City | SOUTH LAKE TAHOE |
| State | CA |
| Zip Code | 96150-3525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750818969 | Terri Wong | Behavior Technician | 908 Alameda Ave, #b, South Lake Tahoe, CA 96150 | 2017-05-18 |
| 1154735157 | Catherine Anne Jones | Dental Hygienist | 1088 4th St # 6, South Lake Tahoe, CA 96150 | 2014-06-17 |
| 1245663194 | Sheila Marie Gwin | Behavioral Analyst | 2111south Ave, South Lake Tahoe, CA 96150 | 2013-08-14 |
| 1164785598 | Launa Jean Martin | Doula | 1399 Bozeman Dr, South Lake Tahoe, CA 96150 | 2012-06-20 |
| 1881957355 | Elizabeth Marilyn Mcnamara | Emergency Medicine | Barton Memorial Hospital, 2107 South Ave, South Lake Tahoe, CA 96150 | 2012-06-20 |
| 1295034627 | Dana Elizabeth Cox | Chiropractor | 3097 Harrison Ave., # 202, S. Lake Tahoe, CA 96150 | 2011-03-24 |
| 1639485162 | April Lyn Westfall | Dentist | 3358 Sandy Way, # B, S Lake Tahoe, CA 96150 | 2010-08-21 |
| 1700199270 | Rollie E Rohnow | Pharmacist | 1020 Al Tahoe Blvd, Rite Aid Pharmacy, South Lake Tahoe, CA 96150 | 2010-07-26 |
| 1699000455 | Ellen Newell Mccullough | Physical Therapist | 1900 High Meadow Trail, South Lake Tahoe, CA 96150 | 2009-10-13 |
| 1093941148 | Ashley Elizabeth Bedell | Counselor | 1137 Emerald Bay Rd., South Lake Tahoe, CA 96150 | 2009-06-03 |
| Find all providers in zip 96150 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487160388 | Sky Lake Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 586 Glorene Ave, South Lake Tahoe, CA 96150-3907 | 2017-12-15 |
| 1144423021 | Sierra Recovery Center | Substance Abuse Rehabilitation Facility | 921 Macinaw Rd # 3, South Lake Tahoe, CA 96150-3525 | 2007-06-07 |
| 1508053950 | Denise Batten | Substance Abuse Rehabilitation Facility | 1137 Emerald Bay Rd, South Lake Tahoe, NV 69150-6207 | 2007-10-01 |
| 1124215009 | Diane Dee Scofield | Substance Abuse Rehabilitation Facility | 921 Macinaw Rd, #2, South Lake Tahoe, CA 96150-3525 | 2007-09-25 |
| 1780878942 | Sierra Recovery Center | Substance Abuse Rehabilitation Facility | 1137 Emerald Bay Rd, South Lake Tahoe, CA 96150-6207 | 2007-08-30 |
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| 1346857679 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 3480 Hidden Trail Dr, Jamul, CA 91935-2104 | 2020-09-30 |
| 1992312227 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 2810 Camino Del Rio S Ste 106, San Diego, CA 92108-3819 | 2020-09-30 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH LAKE TAHOE |
| Zip Code | 96150 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.