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General NPI Number Information
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NPI Number | 1700443926
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Entity Type | Organization
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Legal Business Name | SISTERS HOME CARE SERVICES, INC.
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Dates
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Enumeration Date | 05/22/2019
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Last Update Date | 05/22/2019
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Provider Practice Location Address
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Address Line | 409 BLOOMINGFIELD DR
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City | BRANDON
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State | FL
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Zip | 33511-7984
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Country | US
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Telephone | 813-654-2329
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Fax |
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Provider Business Mailing Address
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Address Line | 4010 HIGHGATE DR
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City | VALRICO
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State | FL
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Zip | 33594-5310
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Country | US
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Telephone | 813-654-2329
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Fax | 800-654-7519
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. MONICA P DERIVEAU
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Credential |
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Telephone | 813-654-2329
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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