Organization
SIERRA'S RESIDENTIAL SERVICES, INC.
Active
Organization
SIERRA'S RESIDENTIAL SERVICES, INC.
Active
Parent organization
SIERRA'S RESIDENTIAL SERVICES, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
SIERRA'S RESIDENTIAL SERVICES, INC.
Authorized official
SCOTTIE JEFFERY VANHOOK LCSW (CLINICAL DIRECTOR/PRESIDENT)
(910) 257-1156
Entity
Organization
Contact information
Practice address
292 SIERRA TRL, SPRING LAKE, NC 28390-8978
(910) 497-2923
(910) 814-4245
Mailing address
PO BOX 655, LILLINGTON, NC 27546-0655
(910) 257-1156
(919) 498-6289
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL-043-034
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603108
—
NC
05
—
6603401
—
NC
05
—
6603601
—
NC
Enumeration date
12/31/2007
Last updated
12/08/2021
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