Organization
SIERRA CARE AT THE LAKE,LLC
Active
Other names
Sierra Care Clovis
Organization subpart
No
Provider details
NPI number
Authorized official
GARY ANDREW PONTICIELLO (PRESIDENT)
(559) 539-2727
Entity
Organization
Contact information
Practice address
648 W SIERRA AVE, CLOVIS, CA 93612-0151
(559) 325-6100
(559) 553-8840
Mailing address
648 W SIERRA AVE, CLOVIS, CA 93612-0151
(559) 325-6100
(559) 553-8840
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
—
—
313M00000X
Nursing Facility/Intermediate Care Facility
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
315D00000X
Inpatient Hospice
—
—
Other
Enumeration date
09/13/2019
Last updated
09/13/2019
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