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Organization
SIERRA AGAPE CENTER
Active
Organization
SIERRA AGAPE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBALL CONVERSE PIER LMFT (EXECUTIVE DIRECTOR)
(530) 414-1885
Entity
Organization
Contact information
Practice address
15645 ARCHERY VW, TRUCKEE, CA 96161-1419
(530) 414-1885
Mailing address
10153 W RIVER ST, TRUCKEE, CA 96161-2392
(530) 414-1885
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
44285
CA
Other
Enumeration date
11/19/2009
Last updated
10/24/2012
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