Organization
SIERRA RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH FEDOR LADC (EXECUTIVE DIRECTOR)
(530) 541-5190
Entity
Organization
Contact information
Practice address
921 MACINAW RD # 3, SOUTH LAKE TAHOE, CA 96150-3525
(530) 541-5190
(530) 541-6031
Mailing address
1137 EMERALD BAY RD, SOUTH LAKE TAHOE, CA 96150-6207
(520) 541-5190
(530) 541-6031
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
090003FN
CA
Other
Enumeration date
06/07/2007
Last updated
10/03/2007
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