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General NPI Number Information
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NPI Number | 1275334476
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Entity Type | Organization
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Legal Business Name | SISTAS HEALTHCARE SERVICES
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Dates
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Enumeration Date | 03/24/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 2809 BROAD WING DR
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City | ODENTON
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State | MD
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Zip | 21113-6035
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Country | US
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Telephone | 443-722-8601
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Fax |
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Provider Business Mailing Address
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Address Line | 2809 BROAD WING DR
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City | ODENTON
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State | MD
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Zip | 21113-6035
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Country | US
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Telephone | 443-722-8601
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Fax |
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Authorized Official
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Title or Position | REGISTERED NURSE
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Name | DORA ADJEI
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Credential |
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Telephone | 443-722-8601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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