MEDICARE: SISTERLY LOVE HEALTH CARE

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1801303987
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SISTERLY LOVE HEALTH CARE

Provider Business Mailing Address
First Line	:	751 FAR PINES DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77373-7929
Country	:	US
Telephone Number	:	601-594-9480
Fax Number	:

Provider Business Practice Location Address
First Line	:	751 FAR PINES DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77373-7929
Country	:	US
Telephone Number	:	601-594-9480
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	SANDRA MCKNIGHT
Credential	:
Telephone Number	:	601-594-9480

Provider Enumeration Date	:	01/10/2018
Last Update Date	:	08/16/2019

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Directions to “SISTERLY LOVE HEALTH CARE ” Practice Location

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