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General NPI Number Information
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NPI Number | 1255933495
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Entity Type | Organization
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Legal Business Name | SISTERS TENDER CARE
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Dates
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Enumeration Date | 11/12/2020
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Last Update Date | 12/11/2020
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Provider Practice Location Address
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Address Line | 129 MOUNT PARAN DR
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City | SENOIA
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State | GA
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Zip | 30276-3299
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Country | US
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Telephone | 770-378-2360
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 944
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City | SHARPSBURG
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State | GA
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Zip | 30277-0944
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Country | US
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Telephone | 470-269-5667
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | GWEN MOORE
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Credential |
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Telephone | 770-378-2360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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