Organization
SISTA EMPOWHER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KETLY CLEOPHAS MBA (EXECUTIVE DIRECTOR)
(754) 303-8480
Entity
Organization
Contact information
Practice address
11797 SW 16TH ST, PEMBROKE PINES, FL 33025-3791
(754) 303-8480
Mailing address
11797 SW 16TH ST, PEMBROKE PINES, FL 33025-3791
(754) 303-8480
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
251300000X
Local Education Agency (LEA)
—
—
251V00000X
Voluntary or Charitable Agency
Primary
—
—
282J00000X
Religious Nonmedical Health Care Institution
—
—
Other
Enumeration date
11/01/2022
Last updated
11/01/2022
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