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General NPI Number Information
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NPI Number | 1588341986
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Entity Type | Organization
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Legal Business Name | SIERRA COUNSELING AND CONSULTING INC
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Dates
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Enumeration Date | 06/28/2023
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 14100 CHADRON AVE APT 106
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City | HAWTHORNE
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State | CA
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Zip | 90250-8241
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Country | US
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Telephone | 171-459-2188
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Fax |
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Provider Business Mailing Address
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Address Line | 14100 CHADRON AVE APT 106
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City | HAWTHORNE
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State | CA
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Zip | 90250-8241
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Country | US
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Telephone | 171-459-2188
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PHILIP M BOCKARIE
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Credential | BS, MPH
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Telephone | 310-703-6296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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