MEDICARE: BDM SISTER'S GROUP HOME LLC

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	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1790637627
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BDM SISTER'S GROUP HOME LLC

Provider Business Mailing Address
First Line	:	3305 BURGOYNE DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45405-2005
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3305 BURGOYNE DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45405-2005
Country	:	US
Telephone Number	:	937-260-3468
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	STARLAIN NELOMS
Credential	:
Telephone Number	:	937-260-3468

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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