Provider Demographics
NPI:1073348363
Name:2SISTERSERVANTS HOMECARE LLC
Entity type:Organization
Organization Name:2SISTERSERVANTS HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIFRED
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:717-332-8867
Mailing Address - Street 1:5500 EXECUTIVE CENTER DR STE 226B
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-8821
Mailing Address - Country:US
Mailing Address - Phone:980-585-9568
Mailing Address - Fax:
Practice Address - Street 1:5500 EXECUTIVE CENTER DR STE 226B5500
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-8856
Practice Address - Country:US
Practice Address - Phone:980-585-9568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-05
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care