Healthcare Provider Details

I. General information

NPI: 1790310340
Provider Name (Legal Business Name): THE SISTA CIRCLE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2020
Last Update Date: 03/30/2022
Certification Date: 03/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7531 BLUFF RD
GADSDEN SC
29052-9699
US

IV. Provider business mailing address

7531 BLUFF RD
GADSDEN SC
29052-9699
US

V. Phone/Fax

Practice location:
  • Phone: 803-553-9221
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: NICHOLE WILLIAMS
Title or Position: CEO/DIRECTOR
Credential:
Phone: 803-587-2178