=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689509879
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BRAVE HEART SENIORS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/17/2026
-----------------------------------------------------
Last Update Date | 06/17/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1699 KING ST
-----------------------------------------------------
City | ENFIELD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06082-6051
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-784-5015
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1699 KING ST
-----------------------------------------------------
City | ENFIELD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06082-6051
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-784-5015
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ALEXANDRIA BUNN
-----------------------------------------------------
Credential | BUNN
-----------------------------------------------------
Telephone | 413-784-5015
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------