Provider Demographics
NPI:1780409284
Name:SISTERLY LOVE HOUSE OF HEALING
Entity type:Organization
Organization Name:SISTERLY LOVE HOUSE OF HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KASHANA
Authorized Official - Middle Name:
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-274-2051
Mailing Address - Street 1:912 MERCHANTS CT
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-7439
Mailing Address - Country:US
Mailing Address - Phone:919-274-2051
Mailing Address - Fax:
Practice Address - Street 1:912 MERCHANTS CT
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-7439
Practice Address - Country:US
Practice Address - Phone:919-274-2051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health