Healthcare Provider Details

I. General information

NPI: 1386010650
Provider Name (Legal Business Name): SISTER TO SISTER CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2015
Last Update Date: 08/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 WALNUT ST
MINDEN LA
71055-4460
US

IV. Provider business mailing address

504 WALNUT ST
MINDEN LA
71055-4460
US

V. Phone/Fax

Practice location:
  • Phone: 318-505-5160
  • Fax:
Mailing address:
  • Phone: 318-505-5160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number StateLA

VIII. Authorized Official

Name: MS. CHARLOTTE SCOTT
Title or Position: OWNER/MANAGER
Credential:
Phone: 318-505-5160