Healthcare Provider Details

I. General information

NPI: 1306115449
Provider Name (Legal Business Name): SIERRA HOME HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2011
Last Update Date: 11/09/2022
Certification Date: 11/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 LAKESIDE CT STE 204
RENO NV
89509-4896
US

IV. Provider business mailing address

3500 LAKESIDE CT STE 204
RENO NV
89509-4896
US

V. Phone/Fax

Practice location:
  • Phone: 775-359-7272
  • Fax: 775-825-1344
Mailing address:
  • Phone: 775-359-7272
  • Fax: 775-825-1344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number5343PCS-2
License Number StateNV

VIII. Authorized Official

Name: MR. TED GRANEY
Title or Position: OWNER
Credential:
Phone: 775-359-7272