Healthcare Provider Details

I. General information

NPI: 1952234346
Provider Name (Legal Business Name): SISTAS 4 LIFE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3416 B ST SE APT 303
WASHINGTON DC
20019-7428
US

IV. Provider business mailing address

3416 B ST SE APT 303
WASHINGTON DC
20019-7428
US

V. Phone/Fax

Practice location:
  • Phone: 202-425-6421
  • Fax:
Mailing address:
  • Phone: 202-425-6421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: UNITA CRUDUP
Title or Position: CEO
Credential:
Phone: 202-425-6421