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General NPI Number Information
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NPI Number | 1922517119
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Entity Type | Organization
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Legal Business Name | SARAH'S DIVINE HOME HEALTH
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Dates
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Enumeration Date | 09/20/2017
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Last Update Date | 11/15/2022
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Provider Practice Location Address
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Address Line | 1002 BANK STREET EXT
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City | SUFFOLK
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State | VA
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Zip | 23434-3527
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Country | US
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Telephone | 757-364-4928
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Fax |
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Provider Business Mailing Address
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Address Line | 1002 BANK STREET EXT
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City | SUFFOLK
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State | VA
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Zip | 23434-3527
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Country | US
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Telephone | 757-364-4928
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. GLORIA JEAN HUNT
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Credential |
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Telephone | 757-364-4928
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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-1714
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License Number State | VA
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