Provider Demographics
NPI:1356469688
Name:SISTER'S HOME HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:SISTER'S HOME HEALTH SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:MS
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BLAKE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:815-961-2170
Mailing Address - Street 1:1214 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61104-2230
Mailing Address - Country:US
Mailing Address - Phone:815-961-2170
Mailing Address - Fax:815-961-1337
Practice Address - Street 1:1214 E STATE ST
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61104-2230
Practice Address - Country:US
Practice Address - Phone:815-961-2170
Practice Address - Fax:815-961-1337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010114251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147713Medicare Oscar/Certification