1386828770 NPI number — ACADEMY OF THE SIERRAS

Table of content: DR. LISA E. ALLEN DO (NPI 1548225261)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386828770 NPI number — ACADEMY OF THE SIERRAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACADEMY OF THE SIERRAS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WELLSPRING ACADEMY
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386828770
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/21/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 LAMBS CREEK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BREVARD
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28712
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-877-2215
Provider Business Mailing Address Fax Number:
828-877-2762

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 LAMBS CREEK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BREVARD
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-877-2215
Provider Business Practice Location Address Fax Number:
828-877-2762
Provider Enumeration Date:
12/21/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BISHOP
Authorized Official First Name:
MIKE
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
828-877-2215

Provider Taxonomy Codes

  • Taxonomy code: 320700000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)