MEDICARE: THE SISTER CODE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1316514755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE SISTER CODE

Provider Business Mailing Address
First Line	:	3268 N 40TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-3613
Country	:	US
Telephone Number	:	414-698-8218
Fax Number	:

Provider Business Practice Location Address
First Line	:	3268 N 40TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-3613
Country	:	US
Telephone Number	:	414-698-8218
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. SHANONA RENEE DAVIS
Credential	:
Telephone Number	:	414-698-8218

Provider Enumeration Date	:	06/04/2021
Last Update Date	:	06/04/2021

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Directions to “THE SISTER CODE ” Practice Location

Language	Start Address	Practice Location

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