Healthcare Provider Details

I. General information

NPI: 1821854209
Provider Name (Legal Business Name): SANKOFA TRIBE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2024
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 W 11TH ST FL 2
WILMINGTON DE
19801-1315
US

IV. Provider business mailing address

1261 PARISH AVE
CLAYMONT DE
19703-3338
US

V. Phone/Fax

Practice location:
  • Phone: 302-779-2961
  • Fax: 844-222-8986
Mailing address:
  • Phone: 302-597-0179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: MRS. TOMARO MONIQUE PILGRIM
Title or Position: HEALTH AND WELLNESS COACH/DOULA
Credential: HS-BCP, LMSW, CD-PCD
Phone: 302-597-0179