Organization
SIERRA'S RESIDENTIAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTTIE JEFFERY VANHOOK MSW, LCSW (CLINICAL DIRECTOR)
(910) 814-4243
Entity
Organization
Contact information
Practice address
1995 US 421 N, LILLINGTON, NC 27546-7436
(910) 814-4243
(910) 814-4245
Mailing address
PO BOX 655, LILLINGTON, NC 27546-0655
(910) 814-4243
(910) 814-4245
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
C002092
NC
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
C002092
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5950677
—
NC
05
—
6006839
—
NC
05
—
6007305
—
NC
05
—
6603108
—
NC
05
—
6603401
—
NC
05
—
6603601
—
NC
05
—
8300458
—
NC
05
—
8300458B
—
NC
05
—
8300458G
—
NC
05
—
8300458H
—
NC
Enumeration date
09/28/2010
Last updated
09/30/2010
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