Provider Demographics
NPI:1750829164
Name:SENTARA ENTERPRISES
Entity Type:Organization
Organization Name:SENTARA ENTERPRISES
Other - Org Name:SENTARA HOME CARE SERVICES - WILLIAMSBURG
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:L
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-553-3000
Mailing Address - Street 1:535 INDEPENDENCE PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-5176
Mailing Address - Country:US
Mailing Address - Phone:757-553-3000
Mailing Address - Fax:757-382-4957
Practice Address - Street 1:5360 DISCOVERY PARK BLVD STE 200
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2860
Practice Address - Country:US
Practice Address - Phone:757-984-1350
Practice Address - Fax:757-837-4711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-06
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-171575251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health