# SIERRA CARE AT THE LAKE,LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508265414
- **Authorized official:** GARY ANDREW PONTICIELLO (PRESIDENT)
- **Authorized official phone:** (559) 539-1100

## Contact information

- **Practice address:** 33221 GLOBE DR, A, SPRINGVILLE, CA 93265-9715
- **Practice address phone:** (559) 539-1100
- **Mailing address:** 33221 GLOBE DR, SPRINGVILLE, CA 93265-9715
- **Mailing address phone:** (559) 539-1100
- **Mailing address fax:** (559) 539-1200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311Z00000X | Custodial Care Facility | 550003154 | CA | — |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 550003154 | CA | — |
| 314000000X | Skilled Nursing Facility | — | — | Yes |
| 315D00000X | Inpatient Hospice | 550003154 | CA | — |

## Other

- **Enumeration date:** 08/15/2014
- **Last updated:** 07/29/2016