| Sisters Supportive Living Llc | |
|
12173 Waconia St Ne Unit A Blaine MN 55449-5398 | |
| (612) 358-3511 | |
| Not Available |
| Full Name | Sisters Supportive Living Llc |
|---|---|
| Speciality | Case Management |
| Location | 12173 Waconia St Ne Unit A, Blaine, Minnesota |
| Authorized Official Name and Position | Ashley Monique Miller (OWNER CASE MANAGER) |
| Authorized Official Contact | 6123583511 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sisters Supportive Living Llc 12173 Waconia St Ne Unit A Blaine MN 55449-5398 Ph: (612) 358-3511 | Sisters Supportive Living Llc 12173 Waconia St Ne Unit A Blaine MN 55449-5398 Ph: (612) 358-3511 |
| NPI Number | 1457214454 |
|---|---|
| Provider Enumeration Date | 12/05/2025 |
| Last Update Date | 12/05/2025 |
| Certification Date | 12/05/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457214454 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Primary |
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