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Organization
SIERRA CARE AT THE LAKE,LLC
Active
Organization
SIERRA CARE AT THE LAKE,LLC
Active
Other names
Sierra Care Clovis
Organization subpart
No
Provider details
NPI number
Authorized official
GARY ANDREW PONTICIELLO (PRESIDENT)
(559) 539-2727
Entity
Organization
Contact information
Practice address
648 W SIERRA AVE, CLOVIS, CA 93612-0151
(559) 325-6100
(559) 553-8840
Mailing address
648 W SIERRA AVE, CLOVIS, CA 93612-0151
(559) 325-6100
(559) 553-8840
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
—
—
313M00000X
Nursing Facility/Intermediate Care Facility
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
315D00000X
Inpatient Hospice
—
—
Other
Enumeration date
09/13/2019
Last updated
09/13/2019
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