MEDICARE: SISTER TO SISTER CARE SERVICES L.L.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1043803109
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SISTER TO SISTER CARE SERVICES L.L.C

Provider Business Mailing Address
First Line	:	2210 W VIENNA AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53206-1959
Country	:	US
Telephone Number	:	414-915-3018
Fax Number	:

Provider Business Practice Location Address
First Line	:	2210 W VIENNA AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53206-1959
Country	:	US
Telephone Number	:	414-915-3018
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. MIRANDA MARIE PORTER
Credential	:
Telephone Number	:	414-915-3018

Provider Enumeration Date	:	02/18/2021
Last Update Date	:	02/18/2021

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