NPIMap

Organization Active NPI

Sierra Recovery Center

  • Community/Behavioral Health Agency
  • South Lake Tahoe, CA
National Provider Identifier
1346443223
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
090003AN Issued in CA
Legal business name
SIERRA RECOVERY CENTER
Practice address
2677 Reaves St
South Lake Tahoe, CA 96150-3529
Phone
(530) 541-5190
Fax
(530) 541-6031
NPI assigned
Jun 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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
Community/Behavioral Health Agency 251S00000X 090003AN CA Primary

Addresses

Primary practice location

2677 Reaves St
South Lake Tahoe, CA 96150-3529

Mailing address

1137 Emerald Bay Rd
South Lake Tahoe, CA 96150-6207
Phone (530) 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": "1598054400000",
    "number": "1346443223",
    "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": "530-541-5190",
            "fax_number": "530-541-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2677 REAVES ST",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961503529",
            "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": "2020-08-22",
        "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": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "090003AN",
            "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 Aug 22, 2020; 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.