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Organization
SIERRA'S RESIDENTIAL SERVICES, INC.
Active
Organization
SIERRA'S RESIDENTIAL SERVICES, INC.
Active
Parent organization
SIERRA'S RESIDENTIAL SERVICES, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
SIERRA'S RESIDENTIAL SERVICES, INC.
Authorized official
SCOTTIE JEFFERY VANHOOK LCSW (CLINICAL DIRECTOR/PRESIDENT)
(910) 257-1156
Entity
Organization
Contact information
Practice address
21 LANEXA RD, SPRING LAKE, NC 28390-8274
(910) 497-4096
Mailing address
PO BOX 655, LILLINGTON, NC 27546-0655
(910) 257-1156
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-043-039
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603401
—
NC
Enumeration date
12/13/2007
Last updated
12/13/2007
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