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General NPI Number Information
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NPI Number | 1922976133
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Entity Type | Organization
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Legal Business Name | SISTA GIRLS AND FRIENDS INCORPORATED
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Dates
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Enumeration Date | 10/28/2025
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 441 N CHURCH ST
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City | DECATUR
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State | IL
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Zip | 62522-2203
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Country | US
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Telephone | 215-855-4367
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Fax |
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Provider Business Mailing Address
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Address Line | 441 N CHURCH ST
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City | DECATUR
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State | IL
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Zip | 62522-2203
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Country | US
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Telephone | 215-855-4367
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MELVERTA WILKINS
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Credential |
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Telephone | 217-520-7308
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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