Organization
SIERRA HOPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY W CADOTTE (EXECUTIVE DIRECTOR)
(209) 736-6792
Entity
Organization
Contact information
Practice address
1168 BOOSTER WAY, ANGELS CAMP, CA 95222-0159
(209) 736-6792
(209) 736-6861
Mailing address
PO BOX 159, ANGELS CAMP, CA 95222-0159
(209) 736-6792
(209) 736-6861
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AYD000460
—
CA
Enumeration date
09/07/2006
Last updated
01/11/2012
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