Organization
SIERRA RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELIXABETH FEDOR LADC (EXECUTIVE DIRECTOR)
(530) 541-5190
Entity
Organization
Contact information
Practice address
931 MACINAW RD, SOUTH LAKE TAHOE, CA 96150-3525
(530) 541-5440
(530) 541-0456
Mailing address
1137 EMERALD BAY RD, SOUTH LAKE TAHOE, CA 96150-6207
(530) 541-5190
(530) 541-6031
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
090003CN
CA
Other
Enumeration date
05/09/2007
Last updated
08/22/2020
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