Provider Demographics
NPI:1144343609
Name:SIERRA CHILD AND FAMILY SERVICES
Entity type:Organization
Organization Name:SIERRA CHILD AND FAMILY SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-626-2589
Mailing Address - Street 1:PO BOX 1987
Mailing Address - Street 2:
Mailing Address - City:DIAMOND SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95619-1987
Mailing Address - Country:US
Mailing Address - Phone:530-626-3105
Mailing Address - Fax:530-642-1233
Practice Address - Street 1:4250 FOWLER LN. SUITE 204
Practice Address - Street 2:
Practice Address - City:DIAMOND SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:95619
Practice Address - Country:US
Practice Address - Phone:530-626-3105
Practice Address - Fax:530-642-1233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health