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General NPI Number Information
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NPI Number | 1972983294
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Entity Type | Organization
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Legal Business Name | SIERRA HOUSE
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Dates
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Enumeration Date | 06/02/2015
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 11 S MAPLE AVE
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City | EAST ORANGE
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State | NJ
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Zip | 07018-4010
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Country | US
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Telephone | 973-678-3556
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Fax | 973-678-2721
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Provider Business Mailing Address
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Address Line | 70 CHESTNUT ST
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City | EAST ORANGE
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State | NJ
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Zip | 07018-3052
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Country | US
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Telephone | 973-678-3556
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Fax | 973-678-2721
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KEELY FREEMAN
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Credential |
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Telephone | 973-678-3556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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