Provider Demographics
NPI:1366168114
Name:2 SISTERS MINISTRY LLC
Entity type:Organization
Organization Name:2 SISTERS MINISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:DAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:470-851-5347
Mailing Address - Street 1:320 SPRING RIDGE TRCE # B
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-2649
Mailing Address - Country:US
Mailing Address - Phone:470-851-5347
Mailing Address - Fax:
Practice Address - Street 1:320 SPRING RIDGE TRCE # B
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-2649
Practice Address - Country:US
Practice Address - Phone:470-851-5347
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE 2 SISTER MINISTRY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA222111329728Medicaid