Provider Demographics
NPI:1780419259
Name:SISTERLY CARE LLC
Entity type:Organization
Organization Name:SISTERLY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ASHA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCCRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-587-6831
Mailing Address - Street 1:1423 PEMBROKE ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06608-1313
Mailing Address - Country:US
Mailing Address - Phone:203-587-6831
Mailing Address - Fax:
Practice Address - Street 1:1423 PEMBROKE ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06608-1313
Practice Address - Country:US
Practice Address - Phone:203-587-6831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health