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General NPI Number Information
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NPI Number | 1215095781
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Entity Type | Organization
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Legal Business Name | SIERRA HOME HEALTH
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 35 N EDISON WAY STE 37
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City | RENO
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State | NV
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Zip | 89502-2352
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Country | US
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Telephone | 775-787-8880
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Fax |
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Provider Business Mailing Address
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Address Line | 2119 MAIN ST
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City | SUSANVILLE
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State | CA
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Zip | 96130-4701
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Country | US
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Telephone | 530-257-8202
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHNATHAN LEE PERRYMAN
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Credential | M.P.T.
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Telephone | 775-338-4777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 32602
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License Number State | CA
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