Provider Demographics
NPI:1851979397
Name:SISTERLY LOVE HOME CARE, LLC
Entity Type:Organization
Organization Name:SISTERLY LOVE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SIERRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-446-9857
Mailing Address - Street 1:5532 PAGE BLVD APT A
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63112-4124
Mailing Address - Country:US
Mailing Address - Phone:314-446-9857
Mailing Address - Fax:
Practice Address - Street 1:5532 PAGE BLVD APT A
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63112-4124
Practice Address - Country:US
Practice Address - Phone:314-446-9857
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health