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General NPI Number Information
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NPI Number | 1275713174
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Entity Type | Organization
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Legal Business Name | MY SISTER'S KEEPER FAMILY SERVICES, INC.
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Dates
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Enumeration Date | 11/07/2007
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 804 COMMERCE BLVD STE A8
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City | RIVERDALE
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State | GA
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Zip | 30296-3321
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Country | US
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Telephone | 678-760-6599
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Fax |
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Provider Business Mailing Address
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Address Line | 7431 PETUNIA DR
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City | RIVERDALE
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State | GA
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Zip | 30296-1185
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Country | US
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Telephone | 770-994-0607
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Fax | 770-994-6621
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Authorized Official
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Title or Position | EXE. DIRECTO
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Name | MRS. SHARON D. STROMAN
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Credential | MS
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Telephone | 770-994-0607
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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 | 145255627A
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License Number State | GA
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