SIERRA CARE AT THE LAKE,LLC (NPI# 1336799170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336799170 |
| Entity Type | Organization |
| Organization Name | SIERRA CARE AT THE LAKE,LLC |
| Practice Address |
648 W Sierra Ave Clovis CA 93612-0151 |
| Practice Telephone | 5593256100 |
| Practice Fax Number | 5595538840 |
| Mailing Telephone | 5593256100 |
| Mailing Fax Number | 5595538840 |
| Enumeration Date | 2019-09-13 |
| Last Update Date | 2019-09-13 |
| Authorized Official Name | GARY ANDREW PONTICIELLO (PRESIDENT) |
| Authorized Official Telephone | 5595392727 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 311Z00000X | Custodial Care Facility | Nursing & Custodial Care Facilities | ||
| N | 313M00000X | Nursing Facility/Intermediate Care Facility | Nursing & Custodial Care Facilities | ||
| N | 315D00000X | Hospice, Inpatient | Nursing & Custodial Care Facilities | ||
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Sierra Care Clovis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235789462 | Sierra Care At The Lake,llc | Hospice, Inpatient | 33425 Globe Dr, Springville, CA 93265 | 2019-09-19 |
| 1508265414 | Sierra Care At The Lake,llc | Nursing Facility/Intermediate Care Facility | 33221 Globe Dr, A, Springville, CA 93265-9715 | 2014-08-15 |
| Street Address |
648 W SIERRA AVE |
| City | CLOVIS |
| State | CA |
| Zip Code | 93612-0151 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235778002 | Prieto Dental Corporation | Dentist | 2320 Clovis Avenue, Suite 102, Clovis, CA 93612 | 2019-12-27 |
| 1285190827 | Natividad Casillas | Behavior Technician | 20 N Dewitt, Clovis, CA 93612 | 2019-02-19 |
| 1922578988 | Benjamin Harold Davis Jr. | Behavior Technician | Swans Consulting, 20 N Dewitt Ave, Clovis, CA 93612 | 2018-12-03 |
| 1134620651 | Innovative Development & Living Solutions of California | Assisted Living Facility | 32 West Sierra Ave, Clovis, CA 93612 | 2018-02-21 |
| 1427578616 | Mariamajane Sengsiri | Licensed Vocational Nurse | 1244 Estabrook Ave., Clovis, CA 93612 | 2017-06-20 |
| 1417482464 | Tiffanie Guy | Pharmacist | 2810 Willow Ave Apt 206, Clovis, CA 93612 | 2017-04-27 |
| 1194271833 | Daniel Salinas | Specialist/Technologist | 1712 Harvard Ave., Clovis, CA 93612 | 2016-09-01 |
| 1386071447 | Darra Hirsh | Psychologist | 334 Shaw Ave Ste 100, Clovis, CA 93612 | 2013-10-03 |
| 1437400793 | Bashful Elephant | Counselor | 3097 Willow Suite 4, Clovis, CA 93612 | 2012-09-27 |
| 1588930432 | Nghiem Gia Vu | Pharmacist | 695 W Herdn Ave, Clovis, CA 93612 | 2012-03-26 |
| Find all providers in zip 93612 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780171223 | Alamos Care | Skilled Nursing Facility | 2193 Alamos Ave, Clovis, CA 93611 | 2018-04-19 |
| 1225220387 | Clovis Healthcare and Rehabilitation Center, LLC | Skilled Nursing Facility | 1201 N Norris St, Clovis, NM 88101-6371 | 2007-08-13 |
| 1003909987 | Laurel Healthcare of Clovis LLC | Skilled Nursing Facility | 1201 North Norris Street, Clovis, NM 88101-6371 | 2006-10-02 |
| 1659482446 | Laurel Healthcare of Clovis LLC | Skilled Nursing Facility | 1400 West 21st Street, Clovis, NM 88101-4153 | 2006-08-31 |
| 1073569000 | Beverly Healthcare - California Inc | Skilled Nursing Facility | 111 Barstow Ave, Clovis, CA 93612-2225 | 2006-05-25 |
| 1003861089 | Willow Creek Healthcare Center, LLC | Skilled Nursing Facility | 650 W Alluvial Ave, Clovis, CA 93611-6716 | 2006-05-24 |
| 1528059011 | Retirement Ranches, Inc | Skilled Nursing Facility | 2221 Dillon Rd, Clovis, NM 88101-9454 | 2005-11-02 |
| 1184240715 | Jm Healthcare Inc | Skilled Nursing Facility | 650 W Alluvial Ave, Clovis, CA 93611-6716 | 2020-06-19 |
| 1174188270 | Willow Creek Post Acute, LLC | Skilled Nursing Facility | 650 W Alluvial Ave, Clovis, CA 93611-6716 | 2019-05-03 |
| 1508318700 | Dycora Transitional Health - Clovis LLC | Skilled Nursing Facility | 111 Barstow Ave, Clovis, CA 93612-2225 | 2016-11-04 |
| Find all providers in CLOVIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.