Healthcare Provider Details
I. General information
NPI: 1023399771
Provider Name (Legal Business Name): SISTERS CARE HOME CARE AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/07/2011
Last Update Date: 09/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
127 WEST MAIN STREET A
SPRING HOPE NC
27882
US
IV. Provider business mailing address
PO BOX 1690
SPRING HOPE NC
27882-1690
US
V. Phone/Fax
- Phone: 252-478-7400
- Fax: 252-478-7426
- Phone: 252-478-7400
- Fax: 252-478-7426
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | NC |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: MS.
THOMASENE
WILSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 252-813-4587