Provider Demographics
NPI:1902927593
Name:ACADEMY OF THE SIERRAS A HEALTHY LIVING PROGRAM
Entity Type:Organization
Organization Name:ACADEMY OF THE SIERRAS A HEALTHY LIVING PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELLIOT
Authorized Official - Middle Name:
Authorized Official - Last Name:SAINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-467-5507
Mailing Address - Street 1:42675 ROAD 44
Mailing Address - Street 2:
Mailing Address - City:REEDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93654-9146
Mailing Address - Country:US
Mailing Address - Phone:559-638-4570
Mailing Address - Fax:559-638-2685
Practice Address - Street 1:42675 ROAD 44
Practice Address - Street 2:
Practice Address - City:REEDLEY
Practice Address - State:CA
Practice Address - Zip Code:93654-9146
Practice Address - Country:US
Practice Address - Phone:559-638-4570
Practice Address - Fax:559-638-2685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management