Healthcare Provider Details

I. General information

NPI: 1689509879
Provider Name (Legal Business Name): BRAVE HEART SENIORS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1699 KING ST
ENFIELD CT
06082-6051
US

IV. Provider business mailing address

1699 KING ST
ENFIELD CT
06082-6051
US

V. Phone/Fax

Practice location:
  • Phone: 413-784-5015
  • Fax:
Mailing address:
  • Phone: 413-784-5015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDRIA BUNN
Title or Position: OWNER
Credential: BUNN
Phone: 413-784-5015