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Organization
SIERRA WATSON
Active
Organization
SIERRA WATSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIERRA WATSON (ADMINISTRATOR/OWNER)
(678) 886-1384
Entity
Organization
Contact information
Practice address
12610 US HIGHWAY 129, LIVE OAK, FL 32060-6753
(678) 886-1384
(386) 208-0002
Mailing address
12610 US HIGHWAY 129, LIVE OAK, FL 32060-6753
(678) 886-1384
(386) 208-0002
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906883
FL
Other
Enumeration date
03/16/2017
Last updated
03/16/2017
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