MEDICARE: SISTER CODE HAVEN INDUSTRIES

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	251S00000X	Community/Behavioral Health Agency
3	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1447181045
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SISTER CODE HAVEN INDUSTRIES

Provider Business Mailing Address
First Line	:	75 WASHINGTON ST UNIT 122
Second Line	:
City	:	FAIRBURN
State	:	GA
Zip	:	30213-3601
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 WASHINGTON ST UNIT 122
Second Line	:
City	:	FAIRBURN
State	:	GA
Zip	:	30213-3601
Country	:	US
Telephone Number	:	281-901-4717
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTEN LYNNETTE GREEN
Credential	:
Telephone Number	:	470-629-2868

Provider Enumeration Date	:	05/25/2026
Last Update Date	:	05/25/2026

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Directions to “SISTER CODE HAVEN INDUSTRIES ” Practice Location

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