Sierra Blanca Rehabilitation LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SIERRA BLANCA REHABILITATION LLC

Practice address

3401 N Lockwood Dr
Lakeside, AZ 85929

Phone

(928) 368-2060

Fax

(928) 368-2061

NPI assigned

May 24, 2010

Last updated

Feb 2, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Harvey F Pelovsky, NURSING HOME ADMINIS

Title

Owner

Phone

(928) 978-0520

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1274659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296604800000",
    "number": "1760701221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 N LOCKWOOD DR",
            "city": "LAKESIDE",
            "state": "AZ",
            "postal_code": "85929",
            "telephone_number": "928-368-2060",
            "fax_number": "928-368-2061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N LOCKWOOD DR",
            "city": "LAKESIDE",
            "state": "AZ",
            "postal_code": "85929",
            "telephone_number": "928-368-2060",
            "fax_number": "928-368-2061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA BLANCA REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-24",
        "last_updated": "2011-02-02",
        "status": "A",
        "authorized_official_last_name": "PELOVSKY",
        "authorized_official_first_name": "HARVEY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-978-0520",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NURSING HOME ADMINIS"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ann Searles, COTA/L
• Arun D Sherma, MD
• Lea Halverson Siebert, L.AC.
• Sierra Blanca Clinic, LTD.
• Sierra Blanca Rehabilitation LLC
• Solterra at White Mountains, LLC (Solterra at White Mountains)
• Statclinix PLC (StatClinix - Lakeside)
• Step Inn LLC
• Steven D Washburn PC
• Carol Elaine Stewart, FNP

• Skilled Nursing Facility in Lakeside, AZ
• Providers in Lakeside, AZ by specialty
• Skilled Nursing Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2011; 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.