Provider Demographics
NPI:1083351100
Name:SISTERLOVE, INC.
Entity Type:Organization
Organization Name:SISTERLOVE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-549-1457
Mailing Address - Street 1:PO BOX 10558
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310-0558
Mailing Address - Country:US
Mailing Address - Phone:404-254-4734
Mailing Address - Fax:
Practice Address - Street 1:1237 RALPH DAVID ABERNATHY BLVD SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30310-1731
Practice Address - Country:US
Practice Address - Phone:404-505-7777
Practice Address - Fax:404-505-0003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-19
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center