NPIMap

Organization Active NPI

Sierra Recovery Center

  • Substance Abuse Rehabilitation Facility
  • South Lake Tahoe, CA
National Provider Identifier
1144423021
Registry record updated Oct 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
090003FN Issued in CA
Legal business name
SIERRA RECOVERY CENTER
Practice address
921 Macinaw Rd # 3
South Lake Tahoe, CA 96150-3525
Phone
(530) 541-5190
Fax
(530) 541-6031
NPI assigned
Jun 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Elizabeth Fedor, LADC
Title
Executive Director
Phone
(530) 541-5190

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 090003FN CA Primary

Addresses

Primary practice location

921 Macinaw Rd # 3
South Lake Tahoe, CA 96150-3525

Mailing address

1137 Emerald Bay Rd
South Lake Tahoe, CA 96150-6207
Phone (520) 541-5190

National Provider Directory

National Provider Directory
Tax ID family
Sierra Recovery Center9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1144423021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1137 EMERALD BAY RD",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961506207",
            "telephone_number": "520-541-5190",
            "fax_number": "530-541-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 MACINAW RD # 3",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961503525",
            "telephone_number": "530-541-5190",
            "fax_number": "530-541-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "FEDOR",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "530-541-5190",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LADC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "090003FN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lake Tahoe, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.