# SIERRA'S RESIDENTIAL SERVICES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SIERRA'S RESIDENTIAL SERVICES, INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1710160759
- **Legal business name:** SIERRA'S RESIDENTIAL SERVICES, INC.
- **Authorized official:** SCOTTIE JEFFERY VANHOOK LCSW (CLINICAL DIRECTOR/PRESIDENT)
- **Authorized official phone:** (910) 257-1156

## Contact information

- **Practice address:** 21 LANEXA RD, SPRING LAKE, NC 28390-8274
- **Practice address phone:** (910) 497-4096
- **Mailing address:** PO BOX 655, LILLINGTON, NC 27546-0655
- **Mailing address phone:** (910) 257-1156

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL-043-039 | NC | Yes |

## Other

- **Enumeration date:** 12/13/2007
- **Last updated:** 12/13/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 6603401 | — | NC |