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General NPI Number Information
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NPI Number | 1750829164
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Entity Type | Organization
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Legal Business Name | SENTARA ENTERPRISES
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Dates
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Enumeration Date | 02/06/2017
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Last Update Date | 01/09/2020
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Provider Practice Location Address
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Address Line | 5360 DISCOVERY PARK BLVD STE 200
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-2860
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Country | US
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Telephone | 757-984-1350
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Fax | 757-837-4711
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Provider Business Mailing Address
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Address Line | 535 INDEPENDENCE PKWY SUITE 200
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City | CHESAPEAKE
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State | VA
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Zip | 23320-5176
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Country | US
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Telephone | 757-553-3000
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Fax | 757-382-4957
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Authorized Official
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Title or Position | PRESIDENT
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Name | TERESA L EDWARDS
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Credential |
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Telephone | 757-553-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HCO-171575
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License Number State | VA
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