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Organization

SIERRA VISTA RESIDENTIAL CARE HOME,INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MEGAN L KEMPF (VICE PRESIDENT)
(559) 747-0399
Entity
Organization

Contact information

Practice address
782 N SHASTA AVE, FARMERSVILLE, CA 93223-1148
(559) 747-0399
(559) 747-0604
Mailing address
782 N SHASTA AVE, FARMERSVILLE, CA 93223-1148
(559) 747-0399
(559) 747-0604

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
55G188
CA
05
55G365
CA
Enumeration date
08/13/2007
Last updated
11/28/2023
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