=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336846864
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SENSITIVE HEART HEALTH TRAINING AGENCY, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/15/2023
-----------------------------------------------------
Last Update Date | 08/22/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4602 WESTGROVE CT. SUITE C
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23455-5414
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-904-5611
-----------------------------------------------------
Fax | 757-904-5612
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4602 WESTGROVE CT. SUITE C
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23455-5414
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-904-5611
-----------------------------------------------------
Fax | 757-904-5612
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | DORINA K HAYES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 757-904-5611
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------