NPIMap

Organization Active NPI

Sierra'S Residential Services, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Spring Lake, NC
National Provider Identifier
1992980676
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
SIERRA'S RESIDENTIAL SERVICES, INC.
Practice address
292 Sierra TRL
Spring Lake, NC 28390-8978
Phone
(910) 497-2923
Fax
(910) 814-4245
NPI assigned
Dec 31, 2007
Organization subpart
Yes
Parent organization
SIERRA'S RESIDENTIAL SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Authorized official

Name
Scottie Jeffery Vanhook, LCSW
Title
Clinical Director/President
Phone
(910) 257-1156

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL-043-034 NC

Addresses

Primary practice location

292 Sierra TRL
Spring Lake, NC 28390-8978

Mailing address

PO Box 655
Lillington, NC 27546-0655
Phone (910) 257-1156

Other practice location 1

21 Lanexa Rd
Spring Lake, NC 28390-8274
Phone (910) 436-4010

Other practice location 2

665 Lakeridge Dr
Cameron, NC 28326-9332
Phone (919) 499-9178

Other identifiers 3

IdentifierTypeStateIssuer
6603401MedicaidNC
6603108MedicaidNC
6603601MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Sierra'S Residential Services Inc8 organizations share this tax ID, including this one
Part of
Sierra'S Residential Services Inc

Other organizations with this tax ID 7

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": "1199059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1992980676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 655",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "275460655",
            "telephone_number": "910-257-1156",
            "fax_number": "919-498-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 SIERRA TRL",
            "city": "SPRING LAKE",
            "state": "NC",
            "postal_code": "283908978",
            "telephone_number": "910-497-2923",
            "fax_number": "910-814-4245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Lanexa Rd",
            "address_purpose": "LOCATION",
            "city": "Spring Lake",
            "state": "NC",
            "postal_code": "283908274",
            "country_code": "US",
            "telephone_number": "910-436-4010",
            "fax_number": "910-814-4245",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "665 Lakeridge Dr",
            "address_purpose": "LOCATION",
            "city": "Cameron",
            "state": "NC",
            "postal_code": "283269332",
            "country_code": "US",
            "telephone_number": "919-499-9178",
            "fax_number": "910-814-4245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SIERRA'S RESIDENTIAL SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SIERRA'S RESIDENTIAL SERVICES, INC.",
        "enumeration_date": "2007-12-31",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "VANHOOK",
        "authorized_official_first_name": "SCOTTIE",
        "authorized_official_middle_name": "JEFFERY",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR/PRESIDENT",
        "authorized_official_telephone_number": "910-257-1156",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-043-034",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603401",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603108",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603601",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Lake, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.