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General NPI Number Information
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NPI Number | 1497618540
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Entity Type | Organization
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Legal Business Name | HEART OF 4 SISTERS
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/06/2025
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Provider Practice Location Address
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Address Line | 42 GIRARD AVE
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City | WATERBURY
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State | CT
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Zip | 06704-2006
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Country | US
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Telephone | 203-600-6249
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Fax |
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Provider Business Mailing Address
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Address Line | 42 GIRARD AVE
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City | WATERBURY
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State | CT
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Zip | 06704-2006
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Country | US
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Telephone | 203-600-6249
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DISHANDA DELORES BLUE
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Credential |
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Telephone | 203-805-1580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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